Helping millions of migraine sufferers with new drugs
One billion people around the world experience migraine and 25 million days of work and education are lost each year due to it. Previously, there have been no specific treatments to prevent migraine attacks. Available medicines are often ineffective and produce significant side effects.
Research from the National Institute for Health and Care Research (NIHR) Maudsley Biomedical Research Centre has helped to identify novel targets for preventive migraine treatment, and we led and collaborated on clinical trials to show new migraine drugs to be safe and effective.
Development and regulatory approval of new drugs
Maudsley BRC researchers identified a small protein, calcitonin gene-related peptide (CGRP), which is released in sufferers during migraine attacks. Building on this discovery, our research focused on creating novel drugs to reduce the effect of CGRP and the likelihood of a migraine attack.
We unlocked the potential of two novel migraine drug classes that use man-made proteins (like antibodies released in the immune system) to target CGRP directly or to dampen the effects of CGRP in the nervous system.
Four antibodies were developed commercially to reduce CGRP levels or to block its effects. We led or collaborated on the next clinical trials for three drugs (erenumab, fremanezumab, galcanezumab) developed by different pharmaceutical partners. These new drugs were effective in patients who seemed resistant to any previous treatments. These drugs were approved by the US and European regulatory authorities between 2018 and 2022.
Pioneering work on novel and more accessible drugs
Our research has been very important in the development of a second, novel class of drugs which will be cheaper to manufacture. These drugs still work on the CGRP system, using small molecules (known as “gepants”) instead of antibodies. Clinical trials show they can relieve the symptoms of a migraine attack soon after treatment, without side-effects.
This research provided evidence to support the US Food and Drug Administration (FDA) approval of rimegepant and ubrogepant for acute treatment. This new drug class is also effective in the prevention of migraine and two drugs, atogepant and rimegepant, are now approved for prevention by the FDA.
King's researchers contributed to a phase 3 trial that was published in The Lancet showing that atogepant was effective for the preventative treatment of chronic migraine. This and other evidence has supported the NICE draft recommendations of the use of atogepant to prevent chronic and episodic migraines which it is estimated could benefit 170,000 people.
These regulatory approvals will help millions of people who suffer migraine around the world.
Professor Peter Goadsby, Pain theme lead, together with international collaborators, was awarded the prestigious Brain Prize in 2021 for this work.
Professor Peter Goadsby presents at the King's Health Partners Annual Conference 2021
IMPACT AREAS:
Novel Diagnostics and Therapeutics | Industry Collaboration
