Introduction: Migraine is a common debilitating neurological disorder affecting a large proportion of the general population. Calcitonin gene-related peptide (CGRP), a 37-amino acid neuropeptide, plays a key role in the pathophysiology of migraine, and the development of therapies targeting the anti-CGRP pathway has revolutionized the field of migraine treatment.

Methods: An expert task force of neurologists in the United Arab Emirates (UAE) developed and critically assessed recommendations on the use of CGRP-based therapies in migraine treatment and management in the UAE, based on available published literature. A consensus was reached for each statement by means of an open-voting process, based on a predefined agreement level of at least 60%.

Results: The consensus recommendations advocate the need for guidelines for the appropriate use of CGRP-based therapies by defining patient cohorts and appropriate monitoring of therapeutic response as well as standardizing the initiation, assessment, and cessation of treatment. The consensus recommendations were primarily formulated on the basis of international studies, because of the limited availability of regional and local data. As such, they may also act as guidelines for global healthcare providers.

Conclusions: These are the first consensus recommendations for the UAE that address the use of CGRP-based therapies in the treatment and management of migraine, integrating both clinical evidence and medical expertise to enhance clinical judgment and decision-making.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10630270PMC
http://dx.doi.org/10.1007/s40120-023-00550-0DOI Listing

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[CGRP: from neuropeptide to the therapeutic target (background and pathophysiology)].

Fortschr Neurol Psychiatr

July 2024

Neurologische Klinik und Poliklinik, LMU Klinikum Campus Grosshadern, Ludwig-Maximilians-Universität München, München, Germany.

Calcitonin gene-related peptide (CGRP) plays a pivotal role in migraine pathophysiology. The importance of CGRP in migraine became evident from numerous clinical studies investigating CGRP levels both interictally and ictally and reports on the efficacy of CGRP-based migraine therapies. In this paper, the above mentioned studies will be presented and the reader will be introduced to the development of CGRP-based medication.

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In the early 1990s, the neuropeptide calcitonin gene-related peptide (CGRP) was identified as a key messenger in the pathophysiology of migraine and emerged as a treatment target, fundamentally transforming our approach to migraine therapy. While previous prophylactic drugs were non-specific and often caused intolerable side effects, the discovery of CGRP marked the advent of a new era in migraine treatment. The two main classes of CGRP-specific migraine treatments are monoclonal antibodies that bind to CGRP or the CGRP receptor, and CGRP receptor antagonists, the so-called gepants.

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Article Synopsis
  • Migraines significantly diminish quality of life and everyday activities for affected individuals, leading to increased healthcare costs and disruption in work or school, particularly in the UAE where there's a lack of specific guidelines for acute migraine management.
  • A task force of eight UAE neurologists developed expert recommendations for acute migraine treatment, utilizing a Delphi panel of 16 neurologists to reach consensus through a structured survey method.
  • The resulting nine consensus statements will serve as a comprehensive guide for healthcare professionals in the UAE, addressing key areas such as treatment goals, timing, response strategies, and safety in combining therapies.
View Article and Find Full Text PDF

Introduction: Migraine is a common debilitating neurological disorder affecting a large proportion of the general population. Calcitonin gene-related peptide (CGRP), a 37-amino acid neuropeptide, plays a key role in the pathophysiology of migraine, and the development of therapies targeting the anti-CGRP pathway has revolutionized the field of migraine treatment.

Methods: An expert task force of neurologists in the United Arab Emirates (UAE) developed and critically assessed recommendations on the use of CGRP-based therapies in migraine treatment and management in the UAE, based on available published literature.

View Article and Find Full Text PDF

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