Migraine: emerging treatment options for preventive and acute attack therapy.
This review discusses emerging treatments of migraine in the context of what is now available. At present, patients are treated with a range of acute attack medicines or preventive treatments, with many having significant drawbacks. Important unmet needs are acute attack treatments that act by exclusively neural mechanisms with no vascular effects, and effective, well tolerated preventive medicines. Calcitonin gene-related peptide receptor antagonist, vanilloid receptor antagonists and nitric oxide synthase inhibitors are all in clinical trials for acute migraine. Tonaberset (a gap-junction blocker), an inducible nitric oxide synthase inhibitor and botulinum toxin A are in clinical trials for preventive therapy. Device-based approaches using neurostimulation of the occipital nerve are being studied, although the first study of patent foramen ovale closure for migraine prevention failed.
Goadsby
Peter J
PJ
Institute of Neurology, Headache Group, The National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK. peterg@ion.ucl.ac.uk
D000208:Acute Disease; D000700:Analgesics / Q000494:pharmacology / Q000627:therapeutic use*; D000818:Animals; D006801:Humans; D008881:Migraine Disorders / Q000188:drug therapy / Q000503:physiopathology / Q000517:prevention & control*; D017366:Serotonin Receptor Agonists / Q000494:pharmacology / Q000627:therapeutic use; D018170:Sumatriptan / Q000494:pharmacology / Q000627:therapeutic use; D050916:TRPV Cation Channels / Q000037:antagonists & inhibitors / Q000502:physiology; D013678:Technology, Pharmaceutical / Q000639:trends*
D000700:Analgesics; D017366:Serotonin Receptor Agonists; D050916:TRPV Cation Channels; D018170:Sumatriptan