For a disease that has not seen any new medications on the market for over two decades and that did not have any disease-specific preventive medication until 2018, the FDA approval of CGRP inhibitors starting in May 2018 began a whole new frontier of treatment options for people who live with migraine.
CGRP stands for calcitonin gene-related peptide, which is a 37 amino acid peptide that was discovered more than 3 decades ago. It is involved in many different processes in the body, including the transmission of pain, and has long been postulated to play a role in the physiology of migraine.
We encourage people to join the Hope for Migraine group on Facebook which specifically focuses on the new and emerging treatments such as CGRP inhibitors. You can also visit our Migraine Toolbox resource for information on all commonly utilized treatments for migraine, including medical devices, supplements, OTC and alternative options.
Explaining Calcitonin Gene-Related Peptide (CGRP)
As written above, CGRP stands for calcitonin gene-related peptide and is a 37-aminoacid peptide that was discovered more than 3 decades ago. It is involved in many different processes in the body, including the transmission of pain, and has long been postulated to play a role in the physiology of migraine. CGRP is released when neurogenic inflammation occurs or the trigeminal nerve is stimulated, and such inflammation can be caused by a wide variety of triggers such as scents, weather, light, etc. Although there have been many decades of research concerning CGRP and its role with migraine, there are still many unknowns and research is ongoing. What we do know is that when the body releases CGRP the peptide attaches itself to the CGRP receptors in the brain, it causes inflammation, and this frequently triggers a migraine attack. We also know that during a migraine attack, CGRP levels in our bodies are elevated, and people with chronic migraine have elevated CGRP levels all the time. The CGRP inhibitors are designed to stop the peptide from binding to the receptors.
- Aimovig blocks the CGRP receptors so the peptide cannot attach
- Ajovy, Emgality and Vyepti attach themselves to the peptide, making it too big to fit into the receptor
- A New Frontier in Migraine Treatment
- CGRP Inhibitor Stories by Real World Patients
- CGRP Medications and Navigating Social Media
- Ubrelvy: Ushering In A New Era Of Migraine Abortives
- But Wait, There’s More! NURTEC Joins the Migraine Landscape!
- CGRP Inhibitor Vyepti Adds a New Dimension to Preventive Migraine Treatment
- Patient Experiences with CGRP Medications: Early Observations (video)
CGRP Monoclonal Antibodies: Migraine Preventives
The CGRP monoclonal antibodies are large molecule CGRP inhibitors which either attach to the CGRP receptor or the CGRP peptide itself. Three are injectables (Aimovig, Ajovy and Emgality), and one is available via IV infusion (Vyepti)
CGRP Monoclonal Antibodies: Migraine Preventives
Gepants are a new class of migraine medication which are small molecule CGRP inhibitors/antagonist. Some gepants are abortive, some are preventive, and one is used for both. They include Ubrelvy, Nurtec, Qulipta, and Zavzpret.
Download the Migraine Treatment Toolbox
Bring it to your next doctor's appointment and ask your doctor which options would be good to add to your personal migraine treatment toolbox.