CGRP and migraine

CGRP is an important chemical in transmitting pain – and it’s also associated with migraine attacks

New drug treatments target CGRP and can reduce the impact of migraine

What is CGRP?

Calcitonin Gene-Related Peptide is an important chemical involved in transmitting pain signals through the nervous system – and it’s also associated with the triggering of migraine attacks.

It was first discovered in 1984 and has been studied extensively since.

CGRP is a type of protein that is produced by the body and, when it builds up in the nervous system, it triggers receptors which open up the pain pathways and start the migraine attack. It is just one of the complex pain chemicals involved in the migraine mechanism.

What are anti-CGRP drugs?

These are drugs, usually injectables, which stop the action of CGRP. Common drugs used in the treatment of migraine include Aimovig, Ajovy and Emgality, which are all available by prescription from headache specialists at the National Migraine Centre.

Anti-CGRP drugs may be used either as migraine preventers or for acute attacks, depending on the type of medication. This factsheet is about the preventers.

The new anti-CGRP medications for prevention of migraine are known as monocolonal antibody medications (mAbs).

How do mAbs work?

MAbs work by targeting the CGRP peptide or its receptors, so blocking the neurochemical pain pathways involved in the migraine mechanism.

There are two types of these anti-CGRP drugs, which work in slightly different ways.

• Aimovig (erenumab) binds itself to the receptor.
• Ajovy (fremanezumab), Emgality (galcanezumab) and Vyepti (eptinezumab) all bind to the protein itself (the ligand).

These drugs have been studied over the last few years to see how safe and effective they are and they have all recently been approved by the FDA in the United States for use in migraine. Aimovig, Ajovy and Emgality, which can be administered by monthly injections, are now approved in the UK. Eptinezumab (Vyepti) is administered by intravenous injection every three months and is not yet available in the UK.

Learn more about how new anti-CGRP medications can help reduce the impact of migraine with our factsheet.