The CGRP monoclonal antibodies (MABs): new treatments on the horizon
CGRP is a neurotransmitter playing an important role in the migraine attack. Four companies are now developing antibodies to block CGRP and prevent migraines.
Clinical studies are ongoing. The available phase 2 studies (smaller studies performed to prepare the bigger phase 3 studies who can lead the molecule to market), show that efficacy is comparable or a bit better than currently available preventive medications. For example, 50% of patients get a 50% improvement in their migraines, and 30% get 75% improvement (this is true for episodic and chronic migraines). Long term safety needs to be carefully studied, since CGRP plays a role in vascular control (the way the arteries react to the needs of the cells). Good news: up until now the side effects look minimal. No somnolence, no weight gain, no nausea…what a relief! Phase 3 results are expected for 2017. Of course these are not available in Canada unless you participate to a clinical study. And on the down side, the cost of these molecules is likely to be high. We may have to fight to get access to them through the canadian public system. Be prepared.