New drugs in migraine treatment and prophylaxis: telcagepant and topiramate

被引:88
作者
Edvinsson, Lars [1 ]
Linde, Mattias [2 ,3 ,4 ]
机构
[1] Univ Lund Hosp, Dept Internal Med, S-22185 Lund, Sweden
[2] Norwegian Univ Sci & Technol, Dept Neurosci, N-7034 Trondheim, Norway
[3] Univ Gothenburg, Sahlgrenska Acad, Inst Neurosci & Physiol, Gothenburg, Sweden
[4] St Olavs Hosp, Div Neurol & Neurophysiol, Trondheim, Norway
基金
瑞典研究理事会;
关键词
GENE-RELATED-PEPTIDE; CORTICAL SPREADING DEPRESSION; RECEPTOR-LIKE RECEPTOR; ORAL CGRP ANTAGONIST; DOUBLE-BLIND; CONTROLLED-TRIAL; TRIGEMINOVASCULAR SYSTEM; 5-HT1B/1D AGONISTS; BLOOD-FLOW; CALCITONIN;
D O I
10.1016/S0140-6736(10)60323-6
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Although the triptan drugs provide effective relief from migraine for many patients, a substantial number of affected individuals are unresponsive to these compounds, and such therapy can also lead to a range of adverse effects. Telcagepant represents a new class of antimigraine drug-the calcitonin gene-related peptide receptor blockers. This compound exerts its effects by blocking receptors for the calcitonin-gene-related peptide at several sites in the trigeminal and central nervous systems, resulting in pain relief. Telcagepant does not cause vasoconstriction, a major limitation in the use of triptans. Comparisons with triptans in clinical trials for acute treatment of migraine attacks revealed clinical effects similar to those of triptans but better than those of placebo. Telcagepant might provide hope for those who have a poor response to, or are unable to use, older drugs. In patients who need prophylaxis because of frequent attacks of migraine, topiramate is a first-line drug for migraine prevention in many countries; it is generally safe and reasonably well tolerated. Data suggest that topiramate could aid reversion of chronic migraine to episodic migraine.
引用
收藏
页码:645 / 655
页数:11
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