Apr 18, 2019

There is a revolutionary new treatment option for migraine that every healthcare professional should understand; Anti-CGRP Monoclonal Antibodies. These drugs are so effective that current standard of care, Triptans, are likely to fade away someday soon. These new treatment options are much cleaner and more effective. CGRP is a strong vasodilator and is implicated in the genesis of migraine.

20% of women and 6% of men have migraine headaches, so this is a significant public health problem. Monoclonal antibody medications targeting CGRP came onto the market in mid-2018.  There are currently 3 injectable drugs available in this category. Aimovig, Ajovy, and Emgality.  All three drugs have shown statistical advantages over placebo, with typically at least 2 migraines less per month in episodic migraine patients. Many patients get significantly better improvement.  Biohaven is working on a small molecule, oral, rescue CGRP inhibitor called Rimegepant. These drugs are quite safe, with low study drop-out rates, and side effects similar to placebo. The drugs are expensive, but all three medications currently have programs that allow free or extremely low cost access for patients.  The drug companies are anxious for healthcare providers to adopt, so they are visiting anyone who prescribes them even once, and handing out discount cards.  Patients can also find these discounts online. Migraines are a huge and expensive burden to the health care system and these new drugs can be life changing for migraine patients.