Toward mechanism-based treatment of migraine: spotlight on CGRP

Considering calcitonin gene-related peptide (CGRP) as a biomarker of migraine formed a hypothesis that blockade of CGRP would treat migraine. Triptans yielded supportive outcome where headache resolution occurred at the same time of reducing CGRP levels. Exogenous administration of CGRP also triggered a migraine. Targeting CGRP receptor then turned out to be effective, but elevated levels of hepatic enzymes led to trials’ termination. Failure kept the idea alive that targeting CGRP – if it can be done safely – may still carry a potential for migraine treatment. Four new antibody-based drugs are under development that either neutralize CGRP or its...