Revolutionizing migraine management: advances and challenges in CGRP-targeted therapies and their clinical implications.

Autor:	Özge A; Department of Neurology, Algology and Clinical Neurophysiology, Mersin University School of Medicine, Mersin, Türkiye., Baykan B; Department of Neurology and Clinical Neurophysiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Türkiye., Bıçakçı Ş; Department of Neurology, Faculty of Medicine, Cukurova University, Adana, Türkiye., Ertaş M; Department of Neurology and Clinical Neurophysiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Türkiye., Atalar AÇ; Department of Neurology, University Health Sciences, Istanbul Physical Medicine and Rehabilitation Training and Research Hospital, Istanbul, Türkiye., Gümrü S; Pfizer Pharmaceuticals, Istanbul, Türkiye., Karlı N; Department of Neurology, Faculty of Medicine, Uludag University, Bursa, Türkiye.
Jazyk:	angličtina
Zdroj:	Frontiers in neurology [Front Neurol] 2024 Jun 13; Vol. 15, pp. 1402569. Date of Electronic Publication: 2024 Jun 13 (Print Publication: 2024).
DOI:	10.3389/fneur.2024.1402569
Abstrakt:	Migraine, a prevalent neurological disorder, affects approximately 14.1% of the global population and disproportionately impacts females. This debilitating condition significantly compromises quality of life, productivity, and incurs high healthcare costs, presenting a challenge not only to individuals but to societal structures as a whole. Despite advances in our understanding of migraine pathophysiology, treatment options remain limited, necessitating ongoing research into effective therapies. This review delves into the complexity of migraine management, examining the roles of genetic predisposition, environmental influences, personalized treatment approaches, comorbidities, efficacy and safety of existing acute and preventive treatments. It further explores the continuum between migraine and tension-type headaches and discusses the intricacies of treating various migraine subtypes, including those with and without aura. We emphasize the recent paradigm shift toward trigeminovascular activation and the release of vasoactive substances, such as calcitonin gene-related peptide (CGRP), which offer novel therapeutic targets. We assess groundbreaking clinical trials, pharmacokinetic and pharmacodynamic perspectives, safety, tolerability, and the real-world application of CGRP monoclonal antibodies and gepants. In the face of persisting treatment barriers such as misdiagnosis, medication overuse headaches, and limited access to specialist care, we discuss innovative CGRP-targeted strategies, the high cost and scarcity of long-term efficacy data, and suggest comprehensive solutions tailored to Turkiye and developing countries. The review offers strategic recommendations including the formulation of primary care guidelines, establishment of specialized outpatient clinics, updating physicians on novel treatments, enhancing global accessibility to advanced therapies, and fostering patient education. Emphasizing the importance of lifestyle modifications and holistic approaches, the review underscores the potential of mass media and patient groups in disseminating critical health information and shaping the future of migraine management. Competing Interests: AÖ board member of IHS, current president of GMPS, advisory board of TEVA, Abbvie, Lilly and Pfizer Pharmaceuticals; lecturer for additionally İlko, Abdi İbrahim, Biofarma, Drogsan Pharmaceuticals and have loyalty from Springer books. BB has acted in advisory board of Takeda and Pfizer Pharmaceuticals and has received speaker honorarium from Lilly and Novartis. ŞB has acted in advisory board of Novartis, Amgen, Pfizer Pharmaceuticals, and has received speaker honorarium from Novartis. AA has acted in advisory board of Pfizer Pharmaceuticals. ME has acted in advisory board of Novartis and Pfizer Pharmaceuticals, and has received speaker honorarium from Novartis, Lilly, Abdi İbrahim Pharmaceuticals and Ali Raif Pharmaceuticals. SG is an employee of Pfizer. NK has acted in advisory board of Novartis, AbbVie, Amgen, Lilly and Pfizer Pharmaceuticals, and has received speaker honorarium from Novartis. (Copyright © 2024 Özge, Baykan, Bıçakçı, Ertaş, Atalar, Gümrü and Karlı.)
Databáze:	MEDLINE
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