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Nervenheilkunde 2021; 40(03): 140-148
DOI: 10.1055/a-1276-7780
Schwerpunkt

Neues in der Migränetherapie

Calcitonin gene-related peptide (CGRP) und sein Rezeptor als AnsatzpunktNew substances in migraine treatmentTargeting the CGRP pathway
Ruth Ruscheweyh∗
1   Neurologische Klinik und Poliklinik, Klinikum der Ludwig-Maximilians-Universität München
,
Jan Hoffmann∗
2   Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King’s College London
3   NIHR-Wellcome Trust King’s Clinical Research Facility-SLaM Biomedical Research Centre, King’s College Hospital, London
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ZUSAMMENFASSUNG

Migränepatienten brauchen eine wirksame Akuttherapie und in schwereren Fällen auch eine medikamentöse Prophylaxe. In den letzten Jahren sind erstmals gezielt in die Pathophysiologie der Migräne eingreifende Substanzen entwickelt worden, die über die Blockade von CGRP wirken. Dies sind einerseits die Antikörper gegen CGRP und den CGRP-Rezeptor, die prophylaktisch wirken, andererseits die Gepante (CGRP-Rezeptorantagonisten), die sowohl in der Akuttherapie als auch in der Prophylaxe der Migräne eingesetzt werden können. Gemeinsam ist diesen Substanzen ihre gute Verträglichkeit. CGRP-(Rezeptor)-Antikörper haben gegenüber klassischen Prophylaktika den Vorteil eines schnellen Wirkeintritts. Für die Gepante in der Akuttherapie weisen tierexperimentelle Daten darauf hin, dass sie anders als Triptane eventuell nicht zu einem Kopfschmerz bei Medikamentenübergebrauch führen.

ABSTRACT

Migräne patients need effective acute medication and the more severe cases need preventive treatment. Recently, drugs that directly interact with migraine pathophysiology by blocking the CGRP pathway have been developed. On one hand, there are antibodies against CGRP and its receptor, used in migraine prevention. On the other hand, small molecule CGRP receptor antagonists, the gepants, are being developed for both acute therapy and prevention. The two classes of drugs have in common a favourable tolerability profile. CGRP-(receptor)-antibodies have the advantage of a fast onset of action. For the gepants, results from animal research suggest that different from triptans, they might not lead to medication overuse headache.

Schlüsselwörter

Migräne - Calcitonin-gene-related-peptide - Antikörper - Gepante

Key words

Migraine - calcitonin-gene-related-peptide - antibodies - gepants


Publikationsverlauf

Artikel online veröffentlicht:
09. März 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
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