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Role of CGRP in Migraine

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Book cover Calcitonin Gene-Related Peptide (CGRP) Mechanisms

Part of the book series: Handbook of Experimental Pharmacology ((HEP,volume 255))

Abstract

Migraine is a common neurological disorder that afflicts up to 15% of the adult population in most countries, with predominance in females. It is characterized by episodic, often disabling headache, photophobia and phonophobia, autonomic symptoms (nausea and vomiting), and in a subgroup an aura in the beginning of the attack. Although still debated, many researchers consider migraine to be a disorder in which CNS dysfunction plays a pivotal role while various parts of the trigeminal system are necessary for the expression of associated symptoms.

Treatment of migraine has in recent years seen the development of drugs that target the trigeminal sensory neuropeptide calcitonin gene-related peptide (CGRP) or its receptor. Several of these drugs are now approved for use in frequent episodic and in chronic migraine. CGRP-related therapies offer considerable improvements over existing drugs, as they are the first to be designed specifically to act on the trigeminal pain system: they are more specific and have little or no adverse effects. Small molecule CGRP receptor antagonists, gepants, are effective for acute relief of migraine headache, whereas monoclonal antibodies against CGRP (Eptinezumab, Fremanezumab, and Galcanezumab) or the CGRP receptor (Erenumab) effectively prevent migraine attacks. The neurobiology of CGRP signaling is briefly summarized together with key clinical evidence for the role of CGRP in migraine headache, including the efficacy of CGRP-targeted treatments.

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Author information

Authors and Affiliations

  1. Division of Experimental Vascular Research, Department of Clinical Sciences, Lund University, Lund, Sweden

    Lars Edvinsson

  2. Department of Clinical Experimental Research, Glostrup Research Institute, Glostrup Hospital, Glostrup, Denmark

    Lars Edvinsson

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  1. Lars Edvinsson
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Correspondence to Lars Edvinsson .

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Editors and Affiliations

  1. School of Cardiovascular Medicine & Sciences, King’s College London, London, UK

    Susan D. Brain

  2. Department of Health Sciences, University of Florence, Florence, Italy

    Pierangelo Geppetti

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Edvinsson, L. (2019). Role of CGRP in Migraine. In: Brain, S., Geppetti, P. (eds) Calcitonin Gene-Related Peptide (CGRP) Mechanisms. Handbook of Experimental Pharmacology, vol 255. Springer, Cham. https://doi.org/10.1007/164_2018_201

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