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The first migrane-specific drugs to show promise in late-stage clinical trials

A new class of drugs might save you a lot of headaches.

Tibi Puiu
December 4, 2017 @ 4:07 pm

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Nearly 1 in 4 U.S. households includes someone who’s had a migraine episode. Overall, 12% of the population – including children – suffer from migraines, the most predisposed group being women. But despite the prevalence, scientists have only recently managed to target migraine episodes specifically. These new drugs have proven their worth in clinical trials and could end up on pharmaceutical shelves next year.

migraine

Credit: Pixaby.

The first migraine treatment that’s actually targeting the disorder

If you experience migraines often, you probably know a couple of drugs that help either block the pain or prevent it. Popular choices include Tylenol or Advil, for instance. Although these drugs help ease the pain, they’ve never been specifically designed to work against migraines. Instead, these are antidepressants, antihistamines, beta-blockers, triptans, and so on.

“Migraine is too often trivialised as just a headache when, in reality, it can be a debilitating, chronic condition that can destroy lives” said Simon Evans, Chief Executive, Migraine Action. “The effects can last for hours – even days in many cases. An option that can prevent migraine and that is well tolerated is therefore sorely needed and we hope that this marks the start of real change in how this condition is treated and perceived.”

Finally, there are at least two promising new drugs that target receptors in the brain to specifically act against migraines which are showing positive results in clinical trials. The results were published last week.

One such trial is the Phase III STRIVE study which involved 955 patients. Over the span of six months, 50 percent of people using a new drug called Erenumab with a 140mg dose reported half their previous number of migraines. On average, the participants suffered from 8.3 days of episodic migraine attacks before taking the drug. Erenumab could reduce this baseline by 3.7 days at the 140-mg dose. Results from the Migraine Physical Function Impact Diary (MPFID) show patients treated with Erenumab also reported improved physical health and ability to participate in daily activities over the six month trial period.

Erenumab, which was developed by Amgen and Novartis, works its magic by blocking the calcitonin gene-related peptide (CGRP) receptor, which plays a critical role in migraine activation. It is the first and only fully human monoclonal antibody of its kind that’s designed to specifically prevent migraines. The drug addresses all symptoms including headaches, nausea, and sensitivity to light and sound. The findings for the clinical trials were published in The New England Journal of Medicine.

The second trial involved a different drug called Fremanezumab, which was developed by Teva Pharmaceuticals. The drug was injected quarterly for 12 weeks to 1,1130 chronic migraine patients who achieved, on average, a 4.3-day reduction of migraine episodes from a baseline of 13.2 days/month. For some people, the attacks all but vanished. These findings were also published in The New England Journal of Medicine.

Neither of the two drugs appeared to cause any more side effects than a placebo would.

All in all, these results suggest a bright future for patients who have a very limited outlook for treatment to begin with. Both drugs will soon be reviewed by the FDA and, if all goes well, could see the market as early as 2018. One big caveat, however, is cost. Both compounds are very expensive and treatment could cost in the order of multiple thousands of dollars, annually. That’s a quite big headache in and of itself. In time, competition could pull prices down considerably, though. For now, we’ll just have to see how things pan out.

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