The new monoclonal antibody therapy, a milestone in the treatment of migraine?

A new class of migraine-specific drugs is gaining attention after research has shown its effectiveness in reducing the number of attacks and minimizing headache attacks.

Hartford HealthCare Headache Center specialist Dr Sandhya Mehla said the revolutionary part of this treatment, called monoclonal antibody therapy, is that it is “migraine-specific”, whereas other pharmaceutical treatments have been developed for other purposes and used because they help with migraines.

“I am witnessing a change in the landscape. I would say that’s a big step,” she said of the injectable drugs.

The discovery capped 40 years of research for a group of four scientists in Sweden, Denmark and the United States and won them the 2021 Brain Prize, the world’s most prestigious prize in neurology.

This stems, said Dr. Mehla, from the research team better understanding the cause of migraine. The pain, they noted, is caused by an interaction between the trigeminal nerve, which is the largest cranial nerve, and the thin membrane around the brain that senses pain, called the meninges. When anything – stress, allergies, fatigue, hormonal change, barometric pressure – activates the fibers of the trigeminal nerve, they send out chemical signals that cause inflammation and a migraine attack.

The research team named the signals calcitonin gene-related peptides (CGRP). Blocking them with monoclonal antibodies, known as CGRP antagonists, can prevent and halt the migraine attack.

Until now, headache specialists have prescribed drugs developed for conditions like epilepsy, Dr. Mehla said. However, many patients were unable to take them due to the associated side effects.

“We have a lot more options now, and there are fewer side effects with these, so more people can take them,” she said. “That’s good news. Migraine is in our genes, so there’s no cure. But this new class of drugs can help abort them and reduce their frequency.

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