Shu-Ting Chen1, Jr-Wei Wu2,3. 1. Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan. 2. Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, No. 201, Sec. 2, Shi-Pai Rd, Taipei, Taiwan, 11217. cwwu10@vghtpe.gov.tw. 3. College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan. cwwu10@vghtpe.gov.tw.
Abstract
PURPOSE OF REVIEW: Chronic cluster headache (CH) substantially affects patients' quality of life, and treatment remains challenging. The current article reviewed controlled studies for new treatment options targeting calcitonin gene-related peptide (CGRP) or its receptors in CH and discussed the current gaps and future directions for the treatment of chronic CH. RECENT FINDINGS: Two anti-CGRP monoclonal antibodies (i.e., galcanezumab and fremanezumab) completed randomized-control trials for efficacy for the preventive treatment of episodic and chronic CH. Galcanezumab was effective for preventing episodic CH but not chronic CH. Fremanezumab was ineffective in preventing episodic and chronic CH. Studies for other anti-CGRP monoclonal antibodies and CGRP antagonists are still pending for results. There are no randomized controlled trials for CGRP-targeted therapies that showed efficacy for chronic CH prevention. The different responses to galcanezumab between episodic and chronic CH may be due to the study design, i.e., the allowance of concomitant preventive therapies in the chronic CH study but not in the episodic CH study. Another reason for the discrepancies is the different roles and sensitivity of CGRP in chronic CH.
PURPOSE OF REVIEW: Chronic cluster headache (CH) substantially affects patients' quality of life, and treatment remains challenging. The current article reviewed controlled studies for new treatment options targeting calcitonin gene-related peptide (CGRP) or its receptors in CH and discussed the current gaps and future directions for the treatment of chronic CH. RECENT FINDINGS: Two anti-CGRP monoclonal antibodies (i.e., galcanezumab and fremanezumab) completed randomized-control trials for efficacy for the preventive treatment of episodic and chronic CH. Galcanezumab was effective for preventing episodic CH but not chronic CH. Fremanezumab was ineffective in preventing episodic and chronic CH. Studies for other anti-CGRP monoclonal antibodies and CGRP antagonists are still pending for results. There are no randomized controlled trials for CGRP-targeted therapies that showed efficacy for chronic CH prevention. The different responses to galcanezumab between episodic and chronic CH may be due to the study design, i.e., the allowance of concomitant preventive therapies in the chronic CH study but not in the episodic CH study. Another reason for the discrepancies is the different roles and sensitivity of CGRP in chronic CH.
Authors: A Donnet; M Lanteri-Minet; E Guegan-Massardier; G Mick; N Fabre; G Géraud; C Lucas; M Navez; D Valade Journal: J Neurol Neurosurg Psychiatry Date: 2007-04-18 Impact factor: 10.154
Authors: Dimos D Mitsikostas; Lars Edvinsson; Rigmor H Jensen; Zaza Katsarava; Christian Lampl; Andrea Negro; Vera Osipova; Koen Paemeleire; Aksel Siva; Dominique Valade; Paolo Martelletti Journal: J Headache Pain Date: 2014-11-27 Impact factor: 7.277