Eine Innovation in der akuten Migränetherapie: CGRP-Rezeptorantagonisten

Zusammenfassung

Die durch Freisetzung vasoaktiver Neuropeptide, z. B. Calcitonin Gene-Related Peptide (CGRP), aus nozizeptiven perivaskulären Nervenfasern hervorgerufene neurogene Entzündung ist an der Pathogenese des akuten Migräneschmerzes beteiligt. Wie kürzlich gezeigt werden konnte, ist BIBN 4096 BS der erste CGRP-Rezeptorantagonist, der den akuten Migräneschmerz beim Menschen effizient mindert. Dies ist ein weiterer Hinweis dafür, dass das Neuropeptid CGRP mit zur Entstehung der akuten Schmerzattacke bei der Migräne beiträgt. Da BIBN 4096 BS keine vasokonstriktorischen Eigenschaften an meningealen und extrakraniellen Gefäßen besitzt, stellt dieser nichtpeptidische CGRP-Antagonist eine gute Alternative zur Behandlung der akuten Migräneattacke dar, insbesondere bei Patienten mit Kontraindikationen für Triptane und Ergotaminderivate.

Abstract

Neurogenic inflammation caused by the release of vasoactive neuropeptides such as calcitonin gene-related peptide (CGRP) from nociceptive perivascular nerve fibres has been implicated in the development of acute migraine pain. It has recently been demonstrated that the CGRP receptor antagonist BIBN 4096 BS significantly reduces acute pain in migraine. This therapeutic efficacy provides further evidence for a critical role of CGRP in the pathophysiology of migraine. Given the apparent absence of vasoconstrictor activity both in meningeal and extracranial vessels, BIBN 4096 BS may provide an alternative for the treatment of migraine in those patients where triptans and ergotamine derivatives are contraindicated due to their side effects.

Schlüsselwörter

CGRP-Rezeptorantagonist - BIBN 4096 BS - Migräne - Neurogene Entzündung - Triptane

Key words

CGRP receptor antagonist - BIBN 4096 BS - migraine - neurogenic inflammation - triptans

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