Migraine Treatment: The Current Status and New Effective Medicines in Trials (2017)
If a severe throbbing pain hammers your head, lasts for many hours or days. You pop pain killers. It gives you temporary relief and then again comes back. This can be a sign of a migraine.
This form of a headache can get worse if left untreated. Many people usually mistake the symptoms of a migraine for a common headache or sinus, but a migraine is a more serious condition. Stress, any particular food, and hormonal changes can trigger your migraine.
It will be helpful if you can keep a note of your personal triggers. Each time you suffer from a migraine note down the factor that caused it, to remain careful in the future.
World Health Organization ranked Migraine as one of the most debilitating diseases.
Struggle with Migraines
A migraine can affect your daily activities. It can make you sensitive to light, sound or mild physical activities like moving by buses, trains. You may feel like vomiting, nausea or problems in vision.
You may see flashing lights or blurry vision before the onset of a headache. Suddenly you may start noticing that a flickering of light or your favorite dish is giving you a headache.
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A migraine may bring a change in your mood. You may become irritated, depressed or feel exhausted. Many of you may be yawning too frequently before the onset of a headache, a typical symptom to note.
More than 1 in 10 people in the US have migraines. More than 40 million Americans and 10 million Indians suffer from migraines. Many of them might be unaware of the condition which would get worse due to negligence. Women are three times more likely to have migraines than men. About 5 percent of the children who often suffer from headaches may develop migraines.
Under-diagnosis and under-treatment of the migraines worse the condition.
It is believed that brain chemicals, nerves in the brain and blood vessels play the crucial role in causing migraines, but the exact reason is still not properly understood.
Over-the-Counter Migraines Drugs
Over-the-counter medicines like aspirin, ibuprofen, acetaminophen can reduce the migraine pain. The combinations of pain relievers and anti-inflammatory drugs help in decreasing the intensity of a headache but prolong use of these drugs can give you side effects like stomach problems or severe headaches.
Many antidepressants, glucocorticoids, opioids, anti-seizure drugs are also used currently to treat migraines. The well-known antiwrinkle therapy, Botox can also help some people in reducing the migraine pains.
Triptans are most commonly prescribed to treat migraines. Frova, Amerge, Imitrex, Relpax, Zomig are some of the common triptans used to calm down the migraine headaches early.
Triptans are serotonin receptor agonists. They quickly relieve the migraine pain by narrowing the blood vessels in the brain and reduce the swelling. It works best if taken early as a headache starts.
Triptans are ineffective in many people. For these patients, doctors may prescribe dihydroergotamine (Migranal) or ergotamines (Migerot). They are available in many forms like injections, tablets or nasal sprays.
Relaxation training, Chinese therapy-acupuncture are some non-drug therapies that can effectively calm down the migraine pain.
Acupuncture Therapy (image credit: jloungespa)
Effective New Migraine Treatments on the Way
Preventive treatments for migraines are very limited, and it is a critical unmet medical need.
Breakthrough discovery of the role of Calcitonin Gene-Related Peptide (CGRP) in the development of a migraine has created a stir in the migraine research field. CGRP is a neuropeptide whose elevated level plays part in triggering migraine pain.
Nowadays monoclonal antibodies have become an important tool for the development of many novel treatments. These antibodies are made of similar immune cells that recognize and specifically bind to the antigen responsible for the disease and inhibit its function.
Last week, Eli Lilly’s migraine treatment drug, galcanezumab was reported to show promising results in reducing headache in migraine patients in the late-stage clinical study. Galcanezumab is a once-monthly, self-administered injection.
Galcanezumab is a monoclonal antibody that is designed for the prevention of a migraine. It targets and blocks the CGRP receptor that is believed to play the key role in the development of a migraine.
The statistically significant reduction in the number of a monthly migraine headache days was observed compared to those on a dummy treatment. Patients with a chronic migraine on 120 mg dose experienced a reduction of 4.7 days in monthly migraine pains compared to a reduction of only 2.8 days in patients on a dummy treatment.
240 mg dose of galcanezumab reduced 4.6 days of a monthly migraine in patients compared to only 2.8 days in patients on a dummy treatment.
Last year, 70 mg of Amgen/Novartis’ migraine drug, erenumab reduced a monthly migraine headache days of episodic migraine patients in late-stage trials.
Erenumab is a fully human monoclonal antibody specifically designed for the migraine prevention. It is also a CGRP antagonist.
70 mg erenumab reduced 3.2 days of monthly migraine pain in patients, and 140 mg reduced 3.7 days of monthly migraine of patients compared to only 1.8 days reduction in those on a dummy treatment.
This year, Teva’s novel CGRP antagonist, Fremanezumab initiated a late-stage trial in patients having cluster migraines.
Alder Biopharmaceuticals’ lead migraine drug candidate, eptinezumab (anti-CGRP) is being developed as a migraine prevention treatment for patients with chronic and frequent episodic migraine. Currently, the drug is in its late-stage clinical trial.
Till now, the impact of migraines on lives has been underestimated. It affects your capability in work often make you miss work. It declines the family activities and social engagements.
The promising upcoming drugs may help people to enjoy migraine-free days which would assist them to prevent the loss of productivity and social life.