Future drugs for migraine

Farinelli, Ivano; Filippis, Sergio De; Coloprisco, Gabriella; Missori, Serena; Martelletti, Paolo

doi:10.1007/s11739-009-0273-0

Cited by 28 publications

(33 citation statements)

References 54 publications

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“…Further confirmation on the validity of such therapeutic approach for CM results from a study comparing OnabotulinumtoxinA and topiramate [53]. The study reports no particular differences among treatments in terms of efficacy, but there is a significant difference for what concerns safety profiles, which is definitely in favor of OnabotulinumtoxinA.…”

Section: Withdrawal From Drug Abuse and CM Reprophylaxismentioning

confidence: 95%

“…In migraine, topiramate acts by reducing nociceptive transmission at the central system level through trigeminovascular modulation and inhibition of the cortical spreading depression [53]. Migraine's preventative treatment with topiramate at a dosage of 100 mg/day for a 24 weeks period is able to reduce the risk of transformation to a chronic form.…”

Section: Withdrawal From Drug Abuse and CM Reprophylaxismentioning

confidence: 99%

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Chronic migraine: comorbidities, risk factors, and rehabilitation

2010

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Migraine is a serious illness with a spontaneous clinical evolution into a chronic form. In some episodic migraines, increase of crises frequency modifies the headache pattern in the chronic form, defined as chronic migraine (CM), with headache frequency of 15 days/month. One-year prevalence of CM includes around 2-4% of the general population. Migraine progression from episodic to chronic form is realized through a period of time involving several months or years, during which an increase of attack frequency occurs. Migraine shows a wide spectrum of comorbidities, including cardiocerebral, vascular, psychiatric, metabolic, neurologic as well as other pathologies. The single/multiple presence of such comorbidities represents a fixed factor in the process of chronicization into CM. Risk factors including medication overuse headache (MOH), obesity, and lifestyle cooperate in the evolution process to CM. MOH is the most severe complication of CM, and similarly to CM its appearance is gradual. Both CM and MOH show particular genetic background able to favor the appearance of chronicity and abuse. Rehabilitation consists of drug withdrawal procedures, re-prophylaxis through administration of innovative drugs, such as OnabotulinumtoxinA and/or topiramate, to avoid relapsing attacks, and behavioral strategies to minimize the role of risk factors. The initial relief step for drug abusers always relies in drug withdrawal. The feasible diagnostic setting for a CM tailored treatment based on the application of pharmacogenomics will allow us to predetermine the efficacy of single old and new drugs by avoiding abuse due to non-responsivity of the acute drug.

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Section: Withdrawal From Drug Abuse and CM Reprophylaxismentioning

confidence: 95%

Section: Withdrawal From Drug Abuse and CM Reprophylaxismentioning

confidence: 99%

Chronic migraine: comorbidities, risk factors, and rehabilitation

2010

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“…The future in relapse prevention of CM complicated by MOH consists in considering how drugs currently used such as triptans and emerging therapies present responsivity profiles related to well-defined genetic polymorphisms [40][41][42][43].…”

Section: Discussionmentioning

confidence: 99%

Rehabilitating chronic migraine complicated by medication overuse headaches: how can we prevent migraine relapse?

Farinelli¹,

Dionisi

Martelletti³

2010

Intern Emerg Med

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Headache is among the most common neurological symptoms in clinical practice. In some cases of episodic migraine, the headache intensifies into a chronic form, defined as chronic migraine (CM) and such a condition encompasses a headache frequency of 15 days/month, with features similar to those of migraine attacks. The assessment of CM in the US general population ranges around 1.3-2%. Migraine progression from an episodic into a chronic form is realized through a period of time involving several months or years, during which an increase attack frequency occurs. Both Topiramate and Onabotulinum toxin A can be considered to be safe as well as effective medications, therefore, representing a treatment choice. Regarding drug abusers, the initial relief step always consists of drug interruption. Only after detoxification can a new prophylaxis therapy be commenced, which otherwise would be useless from the start. The feasible diagnostic setting for the tailored treatment of CM based on the application of pharmacogenomics will allow us in predetermining the efficacy of a single old and new drugs by avoiding abuse due to non-responsivity of the abused drug.

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“…Insbesondere wurde die Rolle von CGRP bei der Entstehung von Migräne untersucht (im Tierversuch [3, 14,29] und klinisch [5, 10,16,27]). CGRP-Rezeptor-Antagonisten werden erfolgreich in der Migrä-nebehandlung eingesetzt [12,22,24]. Jedoch ist nicht bekannt, ob eine Blockade der peripheren CGRP-Rezeptoren für die Schmerzlinderung ausreicht oder ob auch zentralnervöse CGRP-Rezeptoren mitwirken müssen.…”

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Lindernde Wirkung des CGRP-Antagonismus auf Entzündungsschmerz

Hirsch

Birklein

2014

Schmerz

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The neuropeptide calcitonin gene-related peptide (CGRP) is known to play a major role in the pathogenesis of pain syndromes, in particular migraine pain; however, its implication in inflammatory processes is not well known. The CGRP receptor antagonist BIBN4096BS was shown to reduce migraine pain and trigeminal neuronal activity. An analgesic action of this compound can also be found in rats with induced acute inflammation by injection of complete Freund's adjuvant (CFA) in one hindpaw. In this model the compound reduced inflammatory pain and spinal neuronal activity. Behavioral experiments (Randall-Selitto test) revealed a reversal of the CFA-induced mechanical hyperalgesia in rats after systemic drug administration. In vivo electrophysiological studies performed in rats injected with CFA using recordings of wide dynamic range neurons in deep dorsal horn layers of the lumbar spinal cord, confirmed a reduction of neuronal activity after systemic drug administration. The same considerable amount of reduction occurred after topical administration onto the paw with resulting systemic plasma concentrations in the low nanomolar range. Spinal administration of BIBN4096BS did not modify the neuronal activity in the CFA model which suggests that peripheral blockade of CGRP receptors by BIBN4096BS significantly alleviates inflammatory pain.

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Future drugs for migraine

Cited by 28 publications

References 54 publications

Chronic migraine: comorbidities, risk factors, and rehabilitation

Chronic migraine: comorbidities, risk factors, and rehabilitation

Rehabilitating chronic migraine complicated by medication overuse headaches: how can we prevent migraine relapse?

Lindernde Wirkung des CGRP-Antagonismus auf Entzündungsschmerz

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