For a condition that affects nearly 15 percent of the world's population, there are remarkably few effective treatments for migraine sufferers. A new antibody treatment designed specifically for migraine prevention has just completed Phase III human clinical trials with remarkably positive results, raising hopes of a possible revolution on the horizon for sufferers of this debilitating condition.
For the last few years there has been major work examining the role of the calcitonin gene-related peptide (CGRP) in activating migraines. Research has clearly shown that CGRP contributes to the pain conditions of a migraine, so scientists have been working on developing treatments that block the key CGRP receptors in the brain.
There are currently four separate monoclonal antibody treatments being developed that target this mechanism and three of those drugs are already undergoing Phase III human clinical trials. One of first drugs to fully report Phase III results is called erenumab.
The study, labeled STRIVE (aka: Study to Evaluate the Efficacy and Safety of Erenumab in Migraine Prevention, NCT02456740), is reporting successful results both in efficacy and safety of the drug. Subjects receiving the full dose of erenumab reported a 50 percent reduction in monthly migraine days compared to the placebo group that reported only a 26.6 percent reduction.
"The results of STRIVE represent a real transition for migraine patients from poorly understood, repurposed treatments, to a specific migraine-designed therapy," says Peter Goadsby, one of the authors on the study. "STRIVE, as with the monoclonal antibody developments generally, represents an incredibly important step forward for migraine understanding and migraine treatment."
Another monoclonal antibody being trialed targeting CGRP is called fremanezumab. It also shows similarly successful results from Phase III trials with 41 percent of subjects finding their monthly days suffering from migraines dropping by half.
While these new immunotherapy treatments are tantalizingly close to public use, it is unclear how expensive they will ultimately be. Monoclonal antibody treatments are not traditionally cheap or quick to produce, and with these treatments needing to be delivered as monthly injections for several months it is reasonable to be concerned that this may be a very costly drug – initially, at least.
The success of these CGRP treatments is still a cause for hope, though. For too long migraines have been a black spot in medical research so it is heartening to know that a new and targeted treatment could be on the way.
The erenumab trial results were published in The New England Journal of Medicine, while the fremanezumab trial results were published in The New England Journal of Medicine.
Source: King's College London