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Recent Migraine Developments Reviewed

Calcitonin gene-related peptide antagonists considered safe, tolerable and efficacious

FRIDAY, Oct. 17 (HealthDay News) -- Researchers have developed powerful new drugs for migraine treatment, calcitonin gene-related peptide (CGRP) antagonists, which are considered safe, tolerable and efficacious for acute migraine, according to a review published in the Oct. 18 issue of The Lancet.

In a comment on recent developments in migraine, Stephen D. Silberstein, M.D., of Thomas Jefferson University in Philadelphia, reviewed recent migraine studies for the most promising interventions that could help reduce the disability associated with migraine headaches, based on underlying genetic and physiological risk factors.

The findings indicate that a coordinated management approach to diagnosis and treatment options based on headache types and triggers, and proactive follow-up by a case manager significantly improved patient outcomes. Migraine prophylaxis was not always effective, the author notes. An intravenous CGRP antagonist, olcegepant, was found effective in acute migraine headache, with a two-hour headache response rate of 66 percent compared with 27 percent for placebo. And oral telcagepant at a 300-mg dose was the most promising in moderate and severe migraine: 45.2 percent of patients were pain-free at two hours (compared with placebo 14.3 percent and rizatriptan 33.4 percent); and 39.6 percent had sustained relief from pain at 24 hours (compared with placebo 11 percent and rizatriptan 18.4 percent).

In acute migraine treatment with telcagepant, "Phase III trials are positive with results similar to those with zolmitriptan (5 mg) and an adverse-event profile similar to placebo and lower than that with zolmitriptan," the author concludes.

The author has disclosed financial relationships with several pharmaceutical companies.

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