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EAN 2021 | The future of migraine prevention with CGRP-targeted agents

Dimos-Dimitrios Mitsikostas, MD, PhD, National & Kapodistrian University of Athens, Athens, Greece, shares exciting advancements to come in the preventive migraine treatment space with calcitonin gene-related peptide (CGRP)-targeted agents. One promising area is the development of oral CGRP-targeting antibodies, such as atogepant. Taken as a daily pill, these agents could represent a new convenient option for patients. Further research to determine the optimal use of all the newly available migraine treatments is also needed to optimize patient care. This interview took place during the European Academy of Neurology 2021 congress.

Transcript (edited for clarity)

It’s really a new horizon. In a proportion of patients, CGRP targeting treatments eliminate migraines, indicating that in a proportion of patients, the CGRP pathway is the principal and the key pathway. But this is not the case for most patients. That’s one conclusion. Another very important not saying conclusion, but waiting answer is the upcoming oral CGRP class of drugs. We also we have atogepant, we are waiting for the FDA reply...

It’s really a new horizon. In a proportion of patients, CGRP targeting treatments eliminate migraines, indicating that in a proportion of patients, the CGRP pathway is the principal and the key pathway. But this is not the case for most patients. That’s one conclusion. Another very important not saying conclusion, but waiting answer is the upcoming oral CGRP class of drugs. We also we have atogepant, we are waiting for the FDA reply. I’m convinced or I don’t know, but I have this feeling that it will be approved for migraine prevention as well. And this one is a small one, it penetrates the brain-blood barrier. So we may have some adverse events from the central nervous systems although, have not been recorded in clinical trials, but it’s expecting from a theoretical point of view.

But nevertheless, it will be available drug. A pill, once a day, for those they are, let’s say suffering from syringe phobia, they don’t want syringes, they don’t want injection, which is something normal. Everybody wants to take a drug like the food, by mouth, by that’s a normal way, we are taking things in our body. So, that would be a real competitor. That will be a real challenging for the monoclonal antibodies treatments, and future near future, [inaudible] to show us, which is the best way to use all those available drugs for the best of our patients.

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Disclosures

Prof. Mitsikostas reports the following disclosures:
Research and traveling grants, honoraria and consultation fees from Allergan, Amgen, Biogen, Cefaly, Eli Lily, ElectroCore, Genesis Pharma, Lundbeck, Novartis, Merz, Sanofi, and Teva.
Trials for Cefaly, Eli Lily, ElectroCore, Lundbeck, Novartis, Merz, Sanofi, and Teva.
Associate Editor in the Journal of Headache and Pain.
Co-chair of the Management group of the Headache Scientific Panel at the European Academy of Neurology and President of the Hellenic Headache Society.