Two drugs targeting migraines are in advanced research stages, one of which is being developed by the Israeli Teva pharmaceuticals. According to estimates, at least one of these drugs will be approved next year
A series of clinical trials of new generation drugs for migraine prevention looks promising, with the drugs predicted to enter the market within the next year. This is very good news for millions of migraine sufferers around the world, since current treatment options are limited, and there are no specific drugs for this phenomenon that makes so many lives miserable.
Migraine is mostly associated with a headache, but it actually includes a wide range of symptoms, such as nausea, vomiting, and fatigue, as well as light and noise sensitivity. Any person who has ever dealt with repeated migraines knows that there are many drugs on the market, none of which is specific for migraines. Instead, drugs for other conditions, like depression, high blood pressure or epilepsy, are being used, and therefore have many side effects. For this reason, a drug specifically targeting migraine is exciting news.
Drugs just like this were examined in two clinical trials recently published in the prestigious New England Journal of Medicine. The first drug is a specific antibody directed against the receptor for the protein CGRP, which is involved in transmitting the sensation of pain and plays a role in the illness. An antibody is a protein that is used by our immune system in order to neutralize specific materials that invade the body. Migraine patients have a 2-fold increase of CGRP in their blood during attacks. This increase is so significant, that its levels in the blood differentiate between migraine patients, healthy people and people with a non-migraine headache. This led to the notion that this protein is pivotal in the disease, and therefore neutralizing it may help treat it.
During the trial, the drug, Erenumab, was injected as a preventive treatment for episodic migraine, which is defined as migraines that appear once in a while, less than 15 days in a month, to 955 patients in 121 different locations. To date, this is the only drug that blocks the CGRP receptor in the brain.
The drug was administered subcutaneously for six months and it dramatically reduced the number of migraine attacks: half of the patients that received the high dosage reported a 50% or higher reduction in the number of days in a month in which they suffered from a migraine. "The results of [the clinical trial] represent a real transition for migraine patients from poorly understood, repurposed treatments, to a specific migraine-designed therapy", said Peter Goadsby from King's College Hospital in London in an interview to the website "Science Alert".
Another drug, called Fremanezumab, manufactured by the Israeli Teva pharmaceuticals, was tested on 1,130 chronic migraine patients in another clinical trial. Injection of the drug for 12 weeks reduced the number of days in a month in which the patients experienced a migraine by a third, from 13.2 on average to 8.5. Unlike Erenumab, this drug targets the CGRP molecule itself, and not its receptor. For both drugs, no significant side effects were reported compared to placebo.
Both experiments showed that the given drug had a significant advantage over the placebo, but additional research regarding long term efficacy and safety has to be performed. One thing is for certain – we expect to hear about more and more antibodies directed towards CGRP, since two other companies are developing their version of these antibodies. At least one of these four companies is expected to put out their drug on the market in the upcoming year. Let's hope that the competition will reduce the cost of these treatments, which now stands at 8,500 dollars a year at least.
Goadsby told Migraine Action, a British non-profit organization that aids migraine patients, that the development of these novel drugs "represents an incredibly important step forward for migraine understanding and migraine treatment.” Simon Evans, Chief Executive of Migraine Action added that "migraine is too often trivialized as just a headache when, in reality, it can be a debilitating, chronic condition that can destroy lives…We hope that this marks the start of real change in how this condition is treated and perceived.”
Translated by Elee Shimshoni