Emerging therapies for migraine.
Migraine is a common disabling brain disorder that--considering its clinical and economic impact--is understudied and in need of additional management options. Currently, treatments are classified as preventive or acute-attack therapies, although it is expected that this distinction will become blurred over time. The gap-junction blocker tonabersat, an inducible nitric oxide synthase (NOS) inhibitor and botulinum toxin A are all being investigated in clinical trials as preventive therapies. Device-based approaches using neurostimulation of the occipital nerve have provided promising results, whereas the first study of patent foramen ovale closure for migraine prevention produced disappointing results. Calcitonin gene-related peptide receptor antagonists, vanilloid TRPV1 receptor antagonists and NOS inhibitors are all being investigated in clinical trials for acute migraine. There is much cause for optimism in this area of neurology and considerable benefit awaits our patients.
Goadsby
Peter J
PJ
Institute of Neurology, The National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK. peterg@ion.ucl.ac.uk
D000700:Analgesics / Q000627:therapeutic use; D000818:Animals; D001549:Benzamides / Q000627:therapeutic use; D001578:Benzopyrans / Q000627:therapeutic use; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use; D015740:Calcitonin Gene-Related Peptide / Q000037:antagonists & inhibitors; D002986:Clinical Trials as Topic; D004599:Electric Stimulation Therapy; D006801:Humans; D008881:Migraine Disorders / Q000503:physiopathology / Q000628:therapy*; D009465:Neuromuscular Agents / Q000627:therapeutic use; D050916:TRPV Cation Channels / Q000037:antagonists & inhibitors
D000700:Analgesics; D001549:Benzamides; D001578:Benzopyrans; D009465:Neuromuscular Agents; D050916:TRPV Cation Channels; C494484:TRPV1 receptor; C118706:tonabersat; D019274:Botulinum Toxins, Type A; D015740:Calcitonin Gene-Related Peptide