More Than Just a Headache: CGRP and Migraines
Calcitonin Gene-Related Peptide, or CGRP, was first discovered in 1982 and is a 37-amino acid neuropeptide belonging to the same family as adrenomedullin, amylin, and calcitonin. Elevated blood levels of CGRP are found in individuals with pain from conditions such as arthritis, migraine, and chronic muscular pain.1 Recently, Amgen received approval for Aimovig (Erenumab), a monoclonal antibody antagonist of CGRP that is a once a month injection for the treatment and prevention of migraines.2,3 Migraines are a chronic neurological disorder that cause severe headache pain and other symptoms lasting anywhere from 4-72 hours and are a leading neurological disability. CGRP is a biomarker of migraines, as elevated levels are found during a migraine. Interestingly, CGRP levels are the highest in the 20 to 40-year-old age group, and this age group suffers the most migraines. In treating migraines, Eimovig binds to human CGRP receptors, blocking the receptor and preventing CGRP release. There are also currently several other monoclonal antibody antagonists of CGRP in clinical trials, with promising results. Besides the injectable monoclonal antibody therapies, Ubrogepant, a small-molecule oral drug, is an antagonist that selectively blocks CGRP responses and looks promising in Phase III clinical trials.3
- W.S. Schou, et al., The Journal of Headache and Pain, 18(1), 34 (2017).
- L. Edvinsson et al., Nature Reviews, 14, 338 (2018).