title: Wiping Out CGRP: Potential Cardiovascular Risks.
abstract: Migraine is a common episodic neurovascular brain disorder associated with increased risk of cardio- and cerebrovascular ischemia. Migraine headache is likely caused by activation of the trigeminovascular system and release of calcitonin gene-related peptide (CGRP). Monoclonal antibodies against CGRP or its receptor are currently being evaluated for the prevention of migraine attacks. Preliminary efficacy data are promising. However, because CGRP may act as a vasodilatory safeguard during cerebral and cardiac ischemia, CGRP blockade could transform transient mild ischemic events into full-blown infarcts. Here, we review the cerebro- and cardiovascular risks that might be associated with CGRP blockade and which clinical and preclinical studies should be conducted to better assess the potential safety issues of this new promising class of drug.
authors.affiliation: Division of Vascular Medicine and Pharmacology, Department of Internal Medicine, Erasmus University Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands. Electronic address: a.vanharen-maassenvandenbrink@erasmusmc.nl.
authors.forename: Antoinette
authors.initials: A
authors.lastname: MaassenVanDenBrink
authors.affiliation: Department of Neurology, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands.
authors.forename: Joris
authors.initials: J
authors.lastname: Meijer
authors.affiliation: Department of Pharmacobiology, Cinvestav-Coapa, Czda. Tenorios 235, Col. Granjas-Coapa, Deleg. Tlalpan, 14330 Mexico City, Mexico.
authors.forename: Carlos M
authors.initials: CM
authors.lastname: Villalón
authors.affiliation: Department of Neurology, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands.
authors.forename: Michel D
authors.initials: MD
authors.lastname: Ferrari
mesh_terms: D000818:Animals; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000009:adverse effects* / Q000276:immunology / Q000494:pharmacology*; D015740:Calcitonin Gene-Related Peptide / Q000037:antagonists & inhibitors* / Q000276:immunology / Q000378:metabolism*; D002318:Cardiovascular Diseases / Q000378:metabolism*; D002561:Cerebrovascular Disorders / Q000378:metabolism*; D006801:Humans; D008881:Migraine Disorders / Q000188:drug therapy*; D012307:Risk Factors
chemical_list: D000911:Antibodies, Monoclonal; D015740:Calcitonin Gene-Related Peptide
keywords: CGRP; antibody; cardiac ischemia; cerebral ischemia; migraine