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Targeting CGRP and PACAP-38 in migraine

Novel agents targeting the vasoactive signalling molecule, pituitary adenylate cyclase-activating polypeptide (PACAP), may be used as an alternative to anti-CGRP therapies or in combination, if promising initial results are confirmed, suggested Professor Messoud Ashina, Copenhagen University Hospital, Copenhagen, Denmark, during his plenary lecture at the congress.1 This follows new data showing that PACAP-28, one of …

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SPACE trial: fremanezumab reduces migraine days in children

New data from the Phase 3 SPACE trial show that fremanezumab significantly reduced monthly migraine days (MMD) in children and adolescents aged 6-17 years with episodic migraine and there were no emergent safety signals. In the study of 237 participants, there was a significantly greater reduction in MMD with fremanezumab than placebo at 12 weeks …

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Restarting CGRP mAbs restores efficacy after drug holiday

Further evidence of migraine reduction with CGRP mAbs following a drug holiday comes from a retrospective, open-label, real world study of 337 outpatients treated from 2019 to 2023. Of these, 175 were treated with erenumab, 93 with galcanezumab, and 69 with fremanezumab. At baseline, monthly migraine days (MMDs) were 21 ± 7.2, with a median …

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Gepant efficacy in menstrual migraine

Approximately one in three women with menstrual migraine reported positive responses to gepant treatment in a real world survey of adult patients prescribed gepants at the Jefferson Headache Center, Philadelphia, USA, between June 2020 and July 2024. Of 3545 invitations to participate, 478 (13.4%) individuals (age 49.9±14.5 years, 429 (89.7%) Caucasian, 19 (4.0%) African American) …

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CGRP mAb therapy appears safe and effective with autoimmune comorbidity

CGRP mAb therapy appears safe and effective in patients with migraine and comorbid autoimmune disease (AD)1,2 and in patients taking immunosuppressant drugs,3 and such comorbidities and medication use should not preclude CGRP mAb treatment. However, further research is needed on the full clinical implications. These were the conclusions of the authors of a series of studies …

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Real world constipation rates with CGRP mAbs

As many as half of patients taking CGRP mAbs may report constipation but much depends on constipation history, and few patients need to stop treatment. These are the main findings from real world studies carried out in the UK and Portugal.1,2 In the UK single-centre, retrospective audit of patients with chronic, refractory migraine who received …

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