Migraine is a neurological condition most often characterised by a severe headache. Migraine affects 1 in 10 people in New Zealand with women being affected three times more than men. Unfortunately, current preventative medications do not work for all patients.
Neuropeptides, such as Calcitonin gene-related peptide (CGRP), play a particularly important role in migraine. Elevated blood levels of CGRP have been associated with migraine. CGRP monoclonal antibodies are a new type of treatment for migraine. The medications block CGRP and preventing it binding to receptors in the brain.
CGRP monoclonal antibodies are a preventative treatment that reduce the frequency and severity of migraine attacks. Prior to their development, the only preventive medicine for migraine were medications that had been developed for other conditions but were also found to be useful in treating migraine.
Medsafe has approved two new medications: erenumab (also called Aimovig) and galcanezumab (also called Emgality). Although approved, they are not currently funded by Pharmac in New Zealand.
Both erenumab and galcanezumab are given as a monthly injection under the skin (subcutaneous). Most people can do this themselves after being shown by a doctor or nurse. The medications are well tolerated. The most common side effects are pain or skin reactions at the site of the injection.
CGRP monoclonal antibodies should be initiated under the guidance of a neurologist or specialist in the management of migraine.
