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CGRP-Targeted Therapy for Episodic and Chronic Cluster Headache

  • Chronic Daily Headache (S-J Wang, Section Editor)
  • Published:
Current Pain and Headache Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Chronic cluster headache (CH) substantially affects patients’ quality of life, and treatment remains challenging. The current article reviewed controlled studies for new treatment options targeting calcitonin gene–related peptide (CGRP) or its receptors in CH and discussed the current gaps and future directions for the treatment of chronic CH.

Recent Findings

Two anti-CGRP monoclonal antibodies (i.e., galcanezumab and fremanezumab) completed randomized-control trials for efficacy for the preventive treatment of episodic and chronic CH. Galcanezumab was effective for preventing episodic CH but not chronic CH. Fremanezumab was ineffective in preventing episodic and chronic CH. Studies for other anti-CGRP monoclonal antibodies and CGRP antagonists are still pending for results.

Summary

There are no randomized controlled trials for CGRP-targeted therapies that showed efficacy for chronic CH prevention. The different responses to galcanezumab between episodic and chronic CH may be due to the study design, i.e., the allowance of concomitant preventive therapies in the chronic CH study but not in the episodic CH study. Another reason for the discrepancies is the different roles and sensitivity of CGRP in chronic CH.

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Funding

This analysis was supported in part by grants from the Ministry of Science and Technology of Taiwan (MOST 109–2314-B-075–002, MOST 110–2314-B-075–035-MY2, and MOST 110–2314-B-075–081).

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Author notes

  1. Shu-Ting Chen and Jr-Wei Wu contributed equally to this work.

Authors and Affiliations

  1. Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan

    Shu-Ting Chen

  2. Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, No. 201, Sec. 2, Shi-Pai Rd, Taipei, Taiwan, 11217

    Jr-Wei Wu

  3. College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan

    Jr-Wei Wu

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  1. Shu-Ting Chen
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Correspondence to Jr-Wei Wu.

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STC declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. JWW has received honoraria (as a speaker) from Biogen-Idec and Eli Lilly. He has received travel reimbursement and honoraria from American Academy of Neurology, International Headache Society, and Taiwan Headache Society.

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Chen, ST., Wu, JW. CGRP-Targeted Therapy for Episodic and Chronic Cluster Headache. Curr Pain Headache Rep 26, 667–675 (2022). https://doi.org/10.1007/s11916-022-01070-6

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