Calcitonin gene-related peptide (CGRP) and migraine current understanding and state of development

Headache. 2013 Sep;53(8):1230-44. doi: 10.1111/head.12179. Epub 2013 Jul 12.

Abstract

Calcitonin gene-related peptide (CGRP) is a ubiquitous neuropeptide found at the very centers of the migraine process, both centrally and peripherally. It has been under careful study for approximately 25 years. Several CGRP-receptor antagonists are being evaluated for acute treatment of episodic migraine. Three monoclonal antibodies are being studied for prevention of episodic migraine, and 1 monoclonal antibody is being studied for prevention of chronic migraine. In this review, we discuss the role of CGRP in normal physiology and the consequences of CGRP inhibition for human homeostasis. We then review the current state of development for CGRP-receptor antagonists and CGRP monoclonal antibodies. We close by speculating on the potential clinical role of CGRP antagonism in the acute and preventive treatment of episodic and chronic migraine.

Keywords: antibodies; calcitonin gene-related peptide; chronic migraine; migraine.

Publication types

  • Review

MeSH terms

  • Animals
  • Antibodies, Monoclonal / pharmacology
  • Antibodies, Monoclonal / therapeutic use*
  • Calcitonin Gene-Related Peptide / antagonists & inhibitors*
  • Calcitonin Gene-Related Peptide / metabolism
  • Calcitonin Gene-Related Peptide Receptor Antagonists*
  • Clinical Trials as Topic / trends
  • Comprehension*
  • Humans
  • Migraine Disorders / drug therapy*
  • Migraine Disorders / metabolism
  • Receptors, Calcitonin Gene-Related Peptide / metabolism

Substances

  • Antibodies, Monoclonal
  • Calcitonin Gene-Related Peptide Receptor Antagonists
  • Receptors, Calcitonin Gene-Related Peptide
  • Calcitonin Gene-Related Peptide