Migraines are a leading neurological disorder which cause severe head pain which lasts anywhere from 4-72 hours. Calcitonin gene-related peptide or CGRP is a biomarker that is found at elevated levels during a migraine. Interestingly, CGRP levels are the highest in the 20 to 40-year-old age group who also suffer the most migraines. CGRP was first discovered in 1982 and is a 37-amino acid neuropeptide belonging to the same family as adrenomedullin, amylin, and calcitonin. Elevated blood levels of CGRP are found in individuals with pain from conditions such as arthritis, migraine, and chronic muscular pain.1 Amgen received approval for Aimovig (Erenumab), a monoclonal antibody antagonist of CGRP that is a once-a-month injection for the treatment and prevention of migraines.2,3 In treating migraines, Aimovig binds to human CGRP receptors, blocking the receptor and preventing CGRP release. There are also currently several other monoclonal antibody antagonists of CGRP in clinical trials, with promising results. Besides the monoclonal antibody therapies that are injectables, Ubrogepant, a small-molecule oral drug, is an antagonist that selectively blocks CGRP responses and looks promising in Phase III clinical trials.3
There is no denying that it is an exciting time to be involved with peptides. In recent years peptides have grown not only in the discovery and development stages but are also being approved by the FDA (Food & Drug Administration) at an increasing rate. From cosmetic use to finding a cure for cancer, it is impossible to overlook the importance of peptides.
- W.S. Schou, et al., The Journal of Headache and Pain, 18(1), 34 (2017).
- https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm608120.htm (2018)
- L. Edvinsson et al., Nature Reviews, 14, 338 (2018).