In good news for people suffering from chronic migraines, researchers have identified a medication that can prevent severe headaches before they start. Antibody therapy against a key inflammatory molecule involved in migraines reduces the amount of headaches that patients with chronic migraine experience per month in a phase III trial.
"This therapeutic approach offers new hope for people whose migraines can not be treated with existing medications," said Stephen D Silberstein, of Thomas Jefferson University in the United States. The World Health Organization (WHO) estimates that between 127 and 300 million people worldwide experience chronic migraine, defined as 15 or more headaches per month for at least three months. The disease can be debilitating and although there are several interventions, many only work for a certain time before they can not prevent or relieve pain.
The medication called Fremanezumab is a biological agent that binds and blocks the action of a migraine. badociated protein called peptide related to the calcitonin gene (CGRP). The growing evidence of its importance in migraines has made CGRP a focal point for drug research and development. The peptide is released at high levels during migraine in response to inflammation and triggers a cascade effect that stimulates more CGRP release. This results in a greater sensitivity of the brain to pain.
By blocking this peptide, doctors hope to break the cycle of increased inflammation and increased sensitivity to pain that contributes to migraine headaches. For the study published in the New England Journal of Medicine, the researchers enrolled 1,130 patients and divided them into three groups. The first group received quarterly treatments, the second group received one treatment per month and the third group received placebo injections.
The trial lasted 16 weeks, with a treatment period of 12 weeks. The findings showed that treatment with fremanezumab reduced the number of days patients experienced headache by an average of 4.3 days with quarterly treatment and 4.6 days with monthly treatment. "We saw some patients with a 100% reduction in migraine, others with a 75% reduction," said Silberstein. The level of response varied among patients. The researchers also badyzed how well the therapy worked in relation to each patient's headache burden.
They calculated the percentage of patients who had a reduction of more than 50% in the number of days they experienced a severe or moderate headache per month. Using this measure, the researchers found that 37.6% of patients on the monthly regimen and 40.8% on the quarterly regimen had at least a 50% reduction in the number of moderate headaches per month, compared with 18.1 % in the placebo group.
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