New Migraine Treatment Research Spotlight: Fremanezumab and Erenumab

December 7, 2017

Research in The Right Direction
Among the many challenges faced by the medical community, treating migraines certainly ranks highly. Despite its wide prevalence, researchers are only now beginning to understand the physiological basis for the condition, and there is no singular way to take it on. That said, as has been recently reported on NPR, a class of new pharmaceutical medications described in two recently published studies may represent a breakthrough for migraineurs. [1]

By more directly targeting the parts of the brain associated with migraine, these two related drugs promise to minimize the unfortunate side-effects associated with most current pharmaceutical treatments while being very effective as treatment. If these initial findings hold true—and if the drugs in question are approved by the Food and Drug Administration (FDA)—this could be a major step forward.

Side-Effects & The Status Quo
Before getting into how these drugs work, it’s worth talking about what’s lacking about current pharmaceutical approaches. Largely, there are two factors at play: most of these drugs are not specifically designed for migraine, and taking many of them can lead to serious side-effects. For instance, beta-blockers, normally used to combat high blood pressure, are often prescribed because they stimulate blood flow in the brain, often thought to be at the core of migraines. [2] And while they’re about 50 percent effective in reducing attacks, prolonged use can lead to weight gain, fatigue, nausea, and depression, among other side-effects.

This being the case, researchers felt it necessary to develop something that acts directly on the problem. These newly developed drugs, according to Dr. Peter Goadsby, neurologist and author of one of the studies assessing them, “[these drugs] offer the first migraine treatment that’s actually aimed at the disorder.” [1] There’s a lot to be said for taking the problem on head on.

Calming the Storm
So, what is it about these new drugs that make them so promising? How do they work? Migraine attacks can be described as a kind of lightning storm in the brain; specific areas go through massive electrical shifts, leading to headache, nausea, and the other symptoms. The two newly-developed drugs employ specially-designed antibodies to essentially calm down pain messaging, which minimizes the frequency, duration, and intensity of attacks.

In one of the studies, Dr. Stephen Silberstein and his team at the Jefferson Headache Center in Philadelphia, PA, injected an antibody called “fremanezumab” in one- to three-month intervals in 700 chronic migraine patients (those that experience more than 14 headache days a month). They found that nearly half of their subjects had reduced attacks, with some experiencing near complete eradication of the condition. In the other, Dr. Goadsby and his team found similar results using another antibody, “erenumab.” [1]

The Placebo Effect & The Path Forward
While the results of these studies are encouraging—both antibodies were effective and were associated with fewer side-effects—there were a couple limitations to this work. Not only did these approaches not work for everyone, but, according to Dr. Andrew Hershey of the Cincinnati Children’s Hospital, there was a very strong placebo effect. [1] This is basically when the belief that a medication or treatment works—rather than anything inherent in it—causes actual reductions in symptoms. Hershey also worries about costs, saying “every indication is that they will be fairly expensive compounds.” [1]

Another hurdle here is that these treatments need to be further evaluated prior to receiving FDA approval. The good news, though, is that this federal agency is planning to look at these drugs within the coming months, and there’s a good chance that one or both will be on the market in 2018.

Figuring Out What Works for You
These are promising advances, but it’ll be a while before you can access them, and, even then, they may not work. Given the complexity and variability of migraine, it’s almost a given that a patient will need to try a number of different methods of managing their condition. What works for one migraineur, may not be effective for you. That said, migraine management, in part, means being relentless in your pursuit of a solution; it means being actively involved in treatment; it means being tenacious and never giving up.

If you experience chronic migraine, the team at Migraine Treatment Centers of America is ready to help. These experts employ the latest in technologies and techniques to help manage attacks and improve quality of life for countless migraineurs. Learn more about what they do by calling (855) 300-6822 today!

References
1. Hamilton, J. (2017). New Drugs Could Prevent Migraine Headaches For Some People. [online] NPR.org. Available at: https://www.npr.org/sections/health-shots/2017/12/04/567804150/new-drugs-could-prevent-migraine-headaches-for-some-people [Accessed 5 Dec. 2017].
2. “Beta Blockers For The Treatment Of Migraine Headaches”. 2017. Migraine.Com. Accessed December 5 2017. https://migraine.com/migraine-treatment/beta-blockers-for-migraine-headaches/.

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