There’s currently a rush by four major pharmaceutical companies to develop the next generation of migraine prevention drugs. These drugs all target the calcitonin gene-related peptide (CGRP) which is released in the trigeminal nerve and elsewhere, setting off the cascade of biochemicals that results in a migraine. CGRP also links TMJ to many other chronic pain conditions, such as irritable bowel syndrome (IBS).
There’s a lot of excitement about these new drugs, causing migraine sufferers to raise their hopes, and drug companies to raise their stock prices. But just how effective are they? Let’s look at the data available from the phase 2 trials for each of these drugs to see.
Injectable Migraine Prevention
Currently, all four drugs are being formulated as an injectable migraine prevention intended to be taken on a regular basis to prevent the development of migraines.
Eli Lilly’s formulation, currently designated LY2951742, was tested with 217 subjects in a randomized double blind trial, in which 107 received the drug and 110 received placebo. Subjects had an average of 6.7 headache days per month before treatment. After treatment, their headache days decreased by 4.2, compared to only 3.0 in people who took placebo. Overall, about 70% of people saw a reduction in migraines. Most remarkably, a full third of patients saw a complete elimination of migraines after twice-monthly injections began.
Alder Pharmaceutical’s ALD403 was also tested in a double blind clinical trial that had 116 people on placebo and people receiving varying doses of the drug. About 39% of the 232 people receiving the highest doses of ALD403 saw their migraines drop by 75% per month. What sets LD403 apart is that it’s only injected once every twelve weeks.
Amgen’s AMG334 initially had more modest results, only cutting migraines by about 39%, compared to a 26% reduction in the placebo group. But in an expansion study, tracking results over a full year, people saw their migraines drop by 56%.
The Teva Pharmaceuticals version, TEV-48125, led to a drop of 2.5 days in the lower dosage group and 2.8 days in the higher dosage group, compared to just 1.5 days for placebo.
Don’t Wait for New Drugs
Although many people are excited about the development of these new migraine treatments, there’s no reason to wait for them to become available. The earliest any of them are likely to be available is 2019. And none of them are truly miracle drugs, with relatively modest migraine reduction in all counts.