Migraine is more than a headache – a rethink offers hope | Hacker News

Howard G. Smith MD, AM on Instagram: "Migraine Medication Gives Immediate Relief Atogepant is an oral CGRP receptor antagonist, that is a calcitonin gene-related peptide receptor antagonist, that works exceptionally fast. New York’s Albert Einstein College of Medicine now report a meta-analysis of 3 clinical trials involving 1243 people with episodic and chronic migraines. The studies revealed that atogepant reduced the incidence of migraine on the first day of therapy by as much as 50%. Those taking the drug reported fewer days with migraines over time and an improved quality of life. The 3 studies enrolled predominately white, female participants and must be repeated with a more diverse subject population. Assuming confirmation of these findings, atogepant may offer rapid and welcome migraine relief. https://www.neurology.org/doi/10.1212/WNL.0000000000210212 #migraine #atogepant #cgrp"

0 likes, 0 comments - drhowardsmithreports on January 9, 2025: "Migraine Medication Gives Immediate Relief Atogepant is an oral CGRP receptor antagonist, that is a calcitonin gene-related peptide receptor antagonist, that works exceptionally fast. New York’s Albert Einstein College of Medicine now report a meta-analysis of 3 clinical trials involving 1243 people with episodic and chronic migraines. The studies revealed that atogepant reduced the incidence of migraine on the first day of therapy by as much as 50%. Those taking the drug reported fewer days with migraines over time and an improved quality of life. The 3 studies enrolled predominately white, female participants and must be repeated with a more diverse subject population. Assuming confirmation of these findings, atogepant may offer rapid and welcome migraine relief. https://www.neurology.org/doi/10.1212/WNL.0000000000210212 #migraine #atogepant #cgrp".

Howard G. Smith MD, AM on Instagram: "A New Drug Strategy For Preventing Migraine Headaches The American Headache Society is just out with a position statement recommending the use of anti-CGRP drug therapy for the prevention of migraines. Calcitonin Gene-Related Peptides, CGRPs for short, have been recognized as drivers of these devastating headaches. A meta-analysis of the studies that tested the drugs that block them have proven their effectiveness. These drugs include the antibodies erenumab, marketed as Aimovig, galcanezumab, branded as Emgality, fremanezumab, marketed as Ajovy, and epitinezumab, branded Vyepti. Also extremely effective are the gepant drugs atogepant, marketed Qulipta, zavegepant, branded Zavzpret, rimegepant, marketed as Nurtec, and ubrogepant, marketed as Ubrelvy. Neurologists specializing in the management of headaches have embraced the use of these drugs. They now recommend their use to primary care physicians who manage 75% of patients with migraine headaches. If you are a migraine sufferer, do ask your medical team about these medications. https://headachejournal.onlinelibrary.wiley.com/doi/10.1111/head.14692 https://www.medscape.com/viewarticle/new-first-line-therapies-migraine-2024a1000edv #migraines #CGRP #antibodies #gepants #prevention #headaches"

0 likes, 0 comments - drhowardsmithreports on October 29, 2024: "A New Drug Strategy For Preventing Migraine Headaches The American Headache Society is just out with a position statement recommending the use of anti-CGRP drug therapy for the prevention of migraines. Calcitonin Gene-Related Peptides, CGRPs for short, have been recognized as drivers of these devastating headaches. A meta-analysis of the studies that tested the drugs that block them have proven their effectiveness. These drugs include the antibodies erenumab, marketed as Aimovig, galcanezumab, branded as Emgality, fremanezumab, marketed as Ajovy, and epitinezumab, branded Vyepti. Also extremely effective are the gepant drugs atogepant, marketed Qulipta, zavegepant, branded Zavzpret, rimegepant, marketed as Nurtec, and ubrogepant, marketed as Ubrelvy. Neurologists specializing in the management of headaches have embraced the use of these drugs. They now recommend their use to primary care physicians who manage 75% of patients with migraine headaches. If you are a migraine sufferer, do ask your medical team about these medications. https://headachejournal.onlinelibrary.wiley.com/doi/10.1111/head.14692 https://www.medscape.com/viewarticle/new-first-line-therapies-migraine-2024a1000edv #migraines #CGRP #antibodies #gepants #prevention #headaches".

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Shared and independent roles of CGRP and PACAP in migraine pathophysiology - The Journal of Headache and Pain

The neuropeptides calcitonin gene-related peptide (CGRP) and pituitary adenylate cyclase-activating polypeptide (PACAP) have emerged as mediators of migraine pathogenesis. Both are vasodilatory peptides that can cause migraine-like attacks when infused into people and migraine-like symptoms when injected into rodents. In this narrative review, we compare the similarities and differences between the peptides in both their clinical and preclinical migraine actions. A notable clinical difference is that PACAP, but not CGRP, causes premonitory-like symptoms in patients. Both peptides are found in distinct, but overlapping areas relevant to migraine, most notably with the prevalence of CGRP in trigeminal ganglia and PACAP in sphenopalatine ganglia. In rodents, the two peptides share activities, including vasodilation, neurogenic inflammation, and nociception. Most strikingly, CGRP and PACAP cause similar migraine-like symptoms in rodents that are manifested as light aversion and tactile allodynia. Yet, the peptides appear to act by independent mechanisms possibly by distinct intracellular signaling pathways. The complexity of these signaling pathways is magnified by the existence of multiple CGRP and PACAP receptors that may contribute to migraine pathogenesis. Based on these differences, we suggest PACAP and its receptors provide a rich set of targets to complement and augment the current CGRP-based migraine therapeutics.

F.D.A. Approves New Nasal Spray for Migraines

Pfizer’s treatment applies an approach that is different from some other products, which doctors say may make it safer for people at risk of heart attacks or stroke.