Companies race to get ahead in new approach to tackle migraines

Two recently published clinical studies have demonstrated a new approach using antibodies to target specific chemicals in the brain may help significantly reduce the incidence and severity of migraines.

Through research, it has been determined that a chemical in the brain, calcitonin gene-related peptide (CGRP), is involved in the pain and sensitivity that commonly occur with migraines. According to a report on the BBC, this research has led to a race by four pharmaceutical companies to develop antibodies that neutralise this peptide.

The two clinical trials, published in the New England Journal of Medicine, have evaluated the humanised monoclonal antibodies, fremanezumab (Teva Pharmaceuticals) and erenumab (Novartis), as preventative migraine treatments.

In the trial of fremanezumab, the researchers looked at two dose regimens (quarterly and monthly) versus placebo to evaluate the efficacy in patients suffering with chronic migraine. It was found that fremanezumab, in either dosing regimen, reduced the average number of headache days per month by half in about 40% of the patients (38% in quarterly dosing and 41% in monthly dosing regimen). In the placebo group, this reduction was only found in 18% of patients.

The erenumab trial evaluated the efficacy of the antibody preventing episodic migraine at either a 70 mg or 140 mg dose compared with placebo in a monthly dosing regimen. In this trial, it was found that a reduction by half of migraine days each month was achieved in about 50% of the patients receiving antibody treatment (43.3% with 70 mg dose and 50% with 140 mg dose). This result was also true in 26.6% of patients receiving placebo.

“It's a huge deal because it offers an advance in understanding the disorder and a designer migraine treatment,” explained Prof. Peter Goadsby (erenumab trial leader at the NIHR research centre at King’s) when speaking to the BBC. “It reduces the frequency and severity of headaches. These patients will have parts of their life back and society will have these people back functioning.”

Further research is required to assess the long-term durability and safety of both these antibody migraine treatments.

Migraine occurs in about one in seven people globally and is three-times more prevalent in women than men, according to facts and figures from the Migraine Trust. It is ranked as the seventh most disabling disease globally and is the top among neurological disorders.