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Mode and Site of Action of Therapies Targeting Cgrp Signaling Publisher Pubmed



Labastidaramirez A1 ; Caronna E2, 3 ; Gollion C4 ; Stanyer E1, 5 ; Dapkute A6 ; Braniste D7, 8 ; Naghshineh H9 ; Meksa L10 ; Chkhitunidze N11 ; Gudadze T12 ; Pozorosich P2, 3 ; Burstein R13, 14, 15 ; Hoffmann J1, 16
Authors
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Authors Affiliations
  1. 1. Wolfson Centre for Age-Related Diseases, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, SE1 1UL, United Kingdom
  2. 2. Headache Unit, Neurology Department, Vall d’Hebron Universitary Hospital, Barcelona, Spain
  3. 3. Headache Research Group, Vall d’Hebron Institut de Recerca, Universitat Autonoma de Barcelona, Barcelona, Spain
  4. 4. Department of Neurology, University Hospital of Toulouse, Toulouse, France
  5. 5. Nuffield Department of Clinical Neurosciences, Sleep and Circadian Neuroscience Institute, University of Oxford, Oxford, United Kingdom
  6. 6. Centre of Neurology, Vilnius University, Vilnius, Lithuania
  7. 7. Institute of Neurology and Neurosurgery, Diomid Gherman, Chisinau, Moldova
  8. 8. State University of Medicine and Pharmacy, Nicolae Testemitanu, Moldova
  9. 9. Headache Department, Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Science, Tehran, Iran
  10. 10. Headache Unit, Neurology and Neurosurgery Department, Riga East University Hospital Gailezers, Riga, Latvia
  11. 11. Department of Neurology, Caucasus Medical Centre, Tbilisi, Georgia
  12. 12. Department of Neurology, Christian Hospital Unna, Unna, Germany
  13. 13. Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States
  14. 14. Department of Anesthesia, Harvard Medical School, Boston, MA, United States
  15. 15. Center for Life Science, Room 649, 3 Blackfan Circle, Boston, 02215, MA, United States
  16. 16. NIHR-Wellcome Trust King’s Clinical Research Facility/SLaM Biomedical Research Centre, King’s College Hospital, London, United Kingdom

Source: Journal of Headache and Pain Published:2023


Abstract

Targeting CGRP has proved to be efficacious, tolerable, and safe to treat migraine; however, many patients with migraine do not benefit from drugs that antagonize the CGRPergic system. Therefore, this review focuses on summarizing the general pharmacology of the different types of treatments currently available, which target directly or indirectly the CGRP receptor or its ligand. Moreover, the latest evidence regarding the selectivity and site of action of CGRP small molecule antagonists (gepants) and monoclonal antibodies is critically discussed. Finally, the reasons behind non-responders to anti-CGRP drugs and rationale for combining and/or switching between these therapies are addressed. © 2023, Springer-Verlag Italia S.r.l., part of Springer Nature.