New Monoclonal Antibody Therapy a Milestone in Migraine Treatment?

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A new migraine-specific class of drugs is getting attention after research showed its effectiveness in reducing the number of attacks and minimizing breakthrough headaches.

Dr. Sandhya Mehla, a specialist with the Hartford HealthCare Headache Center, said the revolutionary part of this treatment, called monoclonal antibody therapy, is that it is “migraine specific,” whereas other pharmaceutical treatments have been developed for other purposes and used because they help with migraine.

“I’m witnessing a change in the landscape. I would say this is a milestone,” she said of the injectable medication.

The discovery capped 40 years of research for a group of four scientists in Sweden, Denmark and the United States and earned them the 2021 Brain Prize, the most prestigious award in neurology in the world.

It stems, Dr. Mehla said, from the research team better understanding the cause of migraine. The pain, they noted, is caused by an interaction between the trigeminal nerve, which is the largest cranial nerve, and the thin membrane around the brain that senses pain, called the meninges. When something – stress, allergies, fatigue, hormone shift, barometric pressure – activates fibers in the trigeminal nerve, they send out chemical signals that cause inflammation and migraine headache attack.

The research team dubbed the signals calcitonin gene-related peptides (CGRP). Blocking them with monoclonal antibodies, known as CGRP antagonists, can prevent and abort the migraine attack.

To this point, headache specialists have prescribed medications developed for diseases like epilepsy, Dr. Mehla said. Many patients were unable to take them, however, because of related side effects.

“We have many more options now, and there are fewer side effects with these so more people can take them,” she said. “This is positive news. Migraine is in our genes, so it can’t be cured. But this new class of medications can help abort them and reduce their frequency.”




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