New Oral Drugs for Migraine

Nazia Karsan; Peter J. Goadsby

doi:10.1007/s40263-022-00948-8

New Oral Drugs for Migraine

Nazia Karsan, Peter J. Goadsby^*

^*Corresponding author for this work

Research output: Contribution to journal › Review article › peer-review

12 Citations (Scopus)

Abstract

Migraine is a common and disabling neurological disorder, with several manifestations, of which pain is just one. Despite its worldwide prevalence, there remains a paucity of targeted and effective treatments for the condition, leaving many of those affected underserved by available treatments. Work over the last 30+ years has recently led to the emergence of the first targeted acute and preventive treatments in our practice since the triptan era in the early 1990s, which are changing the landscape of migraine treatment. These include the monoclonal antibodies targeting calcitonin gene-related peptide or its receptor. Evolving work on novel therapeutic targets, as well as continuing to exploit drugs used in other disorders that may also have a therapeutic effect in migraine, is likely to lead to more and more treatments being able to be offered to migraineurs. Future work involves the development of agents that lack vasoconstrictive effects, such as lasmiditan, do not contribute to medication overuse, such as the gepants, and do not interact with other drugs that may be used for the disorder, as well as agents that can act both acutely and preventively, thereby utilising the quantum between acute and preventive drug effects which has been demonstrated with different migraine drugs before. Here we discuss the evolution of oral migraine treatments over the last 5 years, including those that have gained regulatory approval and reached clinical practice, those in development and potential other targets for the future.

Original language	English
Pages (from-to)	933-949
Number of pages	17
Journal	CNS Drugs
Volume	36
Issue number	9
DOIs	https://doi.org/10.1007/s40263-022-00948-8
Publication status	Published - Sept 2022

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10.1007/s40263-022-00948-8

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title = "New Oral Drugs for Migraine",

abstract = "Migraine is a common and disabling neurological disorder, with several manifestations, of which pain is just one. Despite its worldwide prevalence, there remains a paucity of targeted and effective treatments for the condition, leaving many of those affected underserved by available treatments. Work over the last 30+ years has recently led to the emergence of the first targeted acute and preventive treatments in our practice since the triptan era in the early 1990s, which are changing the landscape of migraine treatment. These include the monoclonal antibodies targeting calcitonin gene-related peptide or its receptor. Evolving work on novel therapeutic targets, as well as continuing to exploit drugs used in other disorders that may also have a therapeutic effect in migraine, is likely to lead to more and more treatments being able to be offered to migraineurs. Future work involves the development of agents that lack vasoconstrictive effects, such as lasmiditan, do not contribute to medication overuse, such as the gepants, and do not interact with other drugs that may be used for the disorder, as well as agents that can act both acutely and preventively, thereby utilising the quantum between acute and preventive drug effects which has been demonstrated with different migraine drugs before. Here we discuss the evolution of oral migraine treatments over the last 5 years, including those that have gained regulatory approval and reached clinical practice, those in development and potential other targets for the future.",

author = "Nazia Karsan and Goadsby, {Peter J.}",

note = "Funding Information: NK has no relevant financial disclosures to report. PJG reports, over the last 36 months, grants and personal fees from Eli-Lilly and Company; a grant from Celgene; personal fees from Aeon Biopharma, Allergan/Abbvie, Biohaven Pharmaceuticals Inc., CoolTech LLC, Dr Reddys, Epalex, Impel Neuropharma, Lundbeck, Novartis, Praxis, Sanofi, Satsuma and Teva Pharmaceuticals; personal fees for advice through Gerson Lehrman Group, Guidepoint, SAI Med Partners, Vector Metric; fees for educational materials from CME Outfitters, Omnia Education, WebMD; publishing royalties or fees from Massachusetts Medical Society, Oxford University Press, UptoDate and Wolters Kluwer; and for medicolegal advice in headache: and a patent magnetic stimulation for headache (No. WO2016090333 A1) assigned to eNeura without fee. Funding Information: No specific funding was granted for the preparation and publication of this manuscript. Open access was funded by King{\textquoteright}s College London. Publisher Copyright: {\textcopyright} 2022, The Author(s).",

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doi = "10.1007/s40263-022-00948-8",

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N1 - Funding Information: NK has no relevant financial disclosures to report. PJG reports, over the last 36 months, grants and personal fees from Eli-Lilly and Company; a grant from Celgene; personal fees from Aeon Biopharma, Allergan/Abbvie, Biohaven Pharmaceuticals Inc., CoolTech LLC, Dr Reddys, Epalex, Impel Neuropharma, Lundbeck, Novartis, Praxis, Sanofi, Satsuma and Teva Pharmaceuticals; personal fees for advice through Gerson Lehrman Group, Guidepoint, SAI Med Partners, Vector Metric; fees for educational materials from CME Outfitters, Omnia Education, WebMD; publishing royalties or fees from Massachusetts Medical Society, Oxford University Press, UptoDate and Wolters Kluwer; and for medicolegal advice in headache: and a patent magnetic stimulation for headache (No. WO2016090333 A1) assigned to eNeura without fee. Funding Information: No specific funding was granted for the preparation and publication of this manuscript. Open access was funded by King’s College London. Publisher Copyright: © 2022, The Author(s).

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N2 - Migraine is a common and disabling neurological disorder, with several manifestations, of which pain is just one. Despite its worldwide prevalence, there remains a paucity of targeted and effective treatments for the condition, leaving many of those affected underserved by available treatments. Work over the last 30+ years has recently led to the emergence of the first targeted acute and preventive treatments in our practice since the triptan era in the early 1990s, which are changing the landscape of migraine treatment. These include the monoclonal antibodies targeting calcitonin gene-related peptide or its receptor. Evolving work on novel therapeutic targets, as well as continuing to exploit drugs used in other disorders that may also have a therapeutic effect in migraine, is likely to lead to more and more treatments being able to be offered to migraineurs. Future work involves the development of agents that lack vasoconstrictive effects, such as lasmiditan, do not contribute to medication overuse, such as the gepants, and do not interact with other drugs that may be used for the disorder, as well as agents that can act both acutely and preventively, thereby utilising the quantum between acute and preventive drug effects which has been demonstrated with different migraine drugs before. Here we discuss the evolution of oral migraine treatments over the last 5 years, including those that have gained regulatory approval and reached clinical practice, those in development and potential other targets for the future.

AB - Migraine is a common and disabling neurological disorder, with several manifestations, of which pain is just one. Despite its worldwide prevalence, there remains a paucity of targeted and effective treatments for the condition, leaving many of those affected underserved by available treatments. Work over the last 30+ years has recently led to the emergence of the first targeted acute and preventive treatments in our practice since the triptan era in the early 1990s, which are changing the landscape of migraine treatment. These include the monoclonal antibodies targeting calcitonin gene-related peptide or its receptor. Evolving work on novel therapeutic targets, as well as continuing to exploit drugs used in other disorders that may also have a therapeutic effect in migraine, is likely to lead to more and more treatments being able to be offered to migraineurs. Future work involves the development of agents that lack vasoconstrictive effects, such as lasmiditan, do not contribute to medication overuse, such as the gepants, and do not interact with other drugs that may be used for the disorder, as well as agents that can act both acutely and preventively, thereby utilising the quantum between acute and preventive drug effects which has been demonstrated with different migraine drugs before. Here we discuss the evolution of oral migraine treatments over the last 5 years, including those that have gained regulatory approval and reached clinical practice, those in development and potential other targets for the future.

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DO - 10.1007/s40263-022-00948-8

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JO - CNS Drugs

JF - CNS Drugs

IS - 9

ER -

New Oral Drugs for Migraine

Abstract

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