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Several monoclonal antibodies that bind to the CGRP receptor or peptide have been approved for prevention of migraine. [2] Nerve activation triggers the release of CGRP and other neuropeptides, leading to inflammation, pain, and swelling. Three small molecule CGRPR antagonists are approved in the U.S. as antimigraine agents.
Galcanezumab, [4] [5] sold under the brand name Emgality, is a humanized monoclonal antibody used for the prevention of migraine. [2] It is also used for the treatment of cluster headaches. [6] A substance called calcitonin gene-related peptide (CGRP) has been shown to be involved in the development of migraine by widening blood vessels in the ...
Eptinezumab, sold under the brand name Vyepti, is a medication used for the preventive treatment of migraine in adults. [6] It is a monoclonal antibody that targets calcitonin gene-related peptides (CGRP) alpha and beta. [6] [8] It is administered by intravenous infusion. [6]
This list of over 500 monoclonal antibodies includes approved and investigational drugs as well as drugs that have been withdrawn from market; consequently, the column Use does not necessarily indicate clinical usage. See the list of FDA-approved therapeutic monoclonal antibodies in the monoclonal antibody therapy page.
Fremanezumab, sold under the brand name Ajovy, is a medication used to prevent migraines in adults. [8] [6] It is given by injection under the skin.[8] [6]The most common side effect is pain and redness at the site of injection. [8]
There are four injectable monoclonal antibodies that target CGRP or its receptor (eptinezumab, erenumab, fremanezumab, and galcanezumab) and the medications have demonstrated efficacy in the preventative treatment of episodic and chronic migraine headaches in phase III randomized clinical trials.
These are the first class of preventive medications originally designed and approved for people with migraine. [27] Monoclonal means all the antibodies are made from the same genetic material, although different MABs may derive from different sources, e.g. from hamster ovarian cells, from yeast cells or from humanized cell cultures.
Treatments with monoclonal antibodies have been investigated to target pituitary adenylate cyclase-activating polypeptide or its receptors for the treatment of primary headache disorders. Alder BioPharmaceuticals's ALD1910, which targets the peptide, began a phase I study in October 2019.
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