Association between Gastrointestinal Diseases and Migraine

Kim, Jemin; Rhew, Kiyon

doi:10.3390/ijerph19074018

Cited by 18 publications

(13 citation statements)

References 32 publications

(26 reference statements)

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“…Migraine patients are at a higher risk of GI disorders, and this relationship is bidirectional, in agreement with the conception of the gut-brain-microbiota axis [ 96 ]. The prevalence of GI diseases was also higher in patients with medications for migraine, both for preventive and acute treatment.…”

Section: Dietary Nutrients May Reduce Gastrointestinal Functional Dis...supporting

confidence: 77%

Nutrition and Calcitonin Gene Related Peptide (CGRP) in Migraine

et al. 2023

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Targeting calcitonin gene-related peptide (CGRP) and its receptor by antibodies and antagonists was a breakthrough in migraine prevention and treatment. However, not all migraine patients respond to CGRP-based therapy and a fraction of those who respond complain of aliments mainly in the gastrointestinal tract. In addition, CGRP and migraine are associated with obesity and metabolic diseases, including diabetes. Therefore, CGRP may play an important role in the functioning of the gut-brain-microflora axis. CGRP secretion may be modulated by dietary compounds associated with the disruption of calcium signaling and upregulation of mitogen-activated kinase phosphatases 1 and 3. CGRP may display anorexigenic properties through induction of anorexigenic neuropeptides, such as cholecystokinin and/or inhibit orexigenic neuropeptides, such as neuropeptide Y and melanin-concentrating hormone CH, resulting in the suppression of food intake, functionally coupled to the activation of the hypothalamic 3′,5′-cyclic adenosine monophosphate. The anorexigenic action of CGRP observed in animal studies may reflect its general potential to control appetite/satiety or general food intake. Therefore, dietary nutrients may modulate CGRP, and CGRP may modulate their intake. Therefore, anti-CGRP therapy should consider this mutual dependence to increase the efficacy of the therapy and reduce its unwanted side effects. This narrative review presents information on molecular aspects of the interaction between dietary nutrients and CGRP and their reported and prospective use to improve anti-CGRP therapy in migraine.

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Section: Dietary Nutrients May Reduce Gastrointestinal Functional Dis...supporting

confidence: 77%

Nutrition and Calcitonin Gene Related Peptide (CGRP) in Migraine

et al. 2023

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“…Strengths of this study included evaluation of the PK and safety effects in patients with migraine instead of healthy adults. Considering that patients with migraine are predisposed to gastrointestinal disorders (e.g., gastroparesis), 50,51 the PK of co‐administered atogepant and ubrogepant could have been altered due to this predisposition. The present study demonstrated that the PK of atogepant and ubrogepant in participants with a history of migraine were consistent with prior studies in heathy adults 32,38 .…”

Section: Discussionmentioning

confidence: 99%

Phase Ib, open‐label, fixed‐sequence, drug–drug interaction, safety, and tolerability study between atogepant and ubrogepant in participants with a history of migraine

et al. 2023

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Objective: To evaluate potential drug-drug interactions of ubrogepant and atogepant.Background: Ubrogepant and atogepant, calcitonin gene-related peptide (CGRP) receptor antagonists, are recently approved drugs for acute and preventive treatment of migraine, respectively. For patients with migraine who are prescribed atogepant for the preventive treatment of migraine, health care providers could prescribe ubrogepant for the acute treatment of breakthrough migraine attacks.Methods: A phase Ib, multi-center, open-label, fixed-sequence study was conducted in participants diagnosed with migraine for at least 1 year. To assess the primary objective of pharmacokinetic interactions in this phase I trial, the highest United States Food and Drug Administration-approved individual dose strengths of atogepant (60 mg once daily) and ubrogepant (100 mg) were utilized, with ubrogepant being administered on a fixed-dose schedule every 3 days, regardless of whether a participant was experiencing a migraine attack. Secondary endpoints included safety and tolerability. Clinical safety measurements were monitored throughout the study. Results:Of the 31 participants enrolled, 26 completed the study. A single dose of ubrogepant had no statistically significant effect on atogepant pharmacokinetics. Coadministration of ubrogepant with atogepant resulted in a 19% increase (geometric mean ratio 118.80, 90% confidence interval [CI] 108.69-129.84) in the ubrogepant area under the plasma concentration-time curve and a 26% increase (geometric mean ratio 125.63, 90% CI 105.58-149.48) in the ubrogepant maximum plasma concentration. These statistically significant changes in ubrogepant exposure were not clinically meaningful, and no new safety concerns were identified for the combination.

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“…When the mechanisms of both diseases are fully elucidated, then the pathophysiological relationship between them will be clearly understood. 60 4.3. Multiple Sclerosis.…”

Section: Gastrointestinal Diseasesmentioning

confidence: 99%

“…Also some GI symptoms including nausea may adversely affect migraine treatment. When the mechanisms of both diseases are fully elucidated, then the pathophysiological relationship between them will be clearly understood …”

Section: Migraine and Other Diseasesmentioning

confidence: 99%

Migraine and Its Treatment from the Medicinal Chemistry Perspective

Pehlivanlar,

Carradori,

Simsek

2024

ACS Pharmacol. Transl. Sci.

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Migraine is a disease of neurovascular origin that affects the quality of life of more than one billion people and ranks sixth among the most common diseases in the world. Migraine is characterized by a moderate or severe recurrent and throbbing headache, accompanied by nausea, vomiting, and photo-phonophobia. It usually starts in adolescence and is twice as common in women as in men. It is classified as with or without aura and has chronic or acute treatment types according to the frequency of occurrence. In acute treatment, analgesics that relieve pain in the fastest way are preferred, while there are different options in chronic treatment. While non-specific methods were used in the treatment of migraine until the 1950s, triptans, ditans, and CGRP-receptor-dependent therapies (monoclonal antibodies and gepants) started to be used in the clinic more recently. In this Review, we focus on the synthesis, side effects, and pharmacological and pharmacokinetic properties of FDA-approved drugs used in acute and preventive-specific treatment of migraine.

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Association between Gastrointestinal Diseases and Migraine

Cited by 18 publications

References 32 publications

Nutrition and Calcitonin Gene Related Peptide (CGRP) in Migraine

Nutrition and Calcitonin Gene Related Peptide (CGRP) in Migraine

Phase Ib, open‐label, fixed‐sequence, drug–drug interaction, safety, and tolerability study between atogepant and ubrogepant in participants with a history of migraine

Migraine and Its Treatment from the Medicinal Chemistry Perspective

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