Abstract | OBJECTIVE: BACKGROUND: METHOD: The authors performed a literature search of Pubmed and Cochrane databases as well as reviewed abstracts presented at meetings: American Headache Society, American Academy of Neurology, European Headache Federation and the Migraine Trust International Symposium, as well as on-line sources. The authors briefly detail the relevant migraine pathophysiology pertaining to 5-HT1F receptor and the CGRP pathway relevant to acute therapies. Recent clinical trials of acute therapies in which 5-HT1F receptor agonists or CGRP receptor antagonists were studied are summarized. RESULTS: Two 5-HT1F receptor agonists have reached phase II clinical trials. One, lasmiditan, has completed 2 phase III clinical trials, demonstrating a significant effect for pain freedom and most bothersome symptom at 2 hours. Among the 6 gepants tested for the acute treatment of migraine to date, after issues for some of hepatic safety or efficacy, 2 CGRP receptor antagonists, rimegepant and ubrogepant, have completed phase III trials showing efficacy and safety. CONCLUSION: Current available therapies have either been nonspecific or had important limitations, including in patients with cardiovascular risk factors. Phase III clinical trials of lasmiditan, rimegepant and ubrogepant all met their primary endpoints, so the options for migraine-targeted acute therapy will likely soon increase.
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Authors | David Moreno-Ajona, Calvin Chan, María Dolores Villar-Martínez, Peter J Goadsby |
Journal | Headache
(Headache)
Vol. 59 Suppl 2
Pg. 3-19
(07 2019)
ISSN: 1526-4610 [Electronic] United States |
PMID | 31291016
(Publication Type: Journal Article, Review)
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Copyright | © 2019 American Headache Society. |
Chemical References |
- Calcitonin Gene-Related Peptide Receptor Antagonists
- Serotonin 5-HT1 Receptor Agonists
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Topics |
- Calcitonin Gene-Related Peptide Receptor Antagonists
(adverse effects, pharmacology)
- Humans
- Migraine Disorders
(drug therapy)
- Serotonin 5-HT1 Receptor Agonists
(adverse effects, pharmacology)
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