Neurology Book

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Calcitonin Gene-Related Peptide Blocker

Aka: Calcitonin Gene-Related Peptide Blocker, CGRP Antagonist, Erenumab, Ajovy, Fremanezumab, Emgality, Galcanezumab, Aimovig
  1. Indications
    1. Migraine Prophylaxis if refractory to first-line agents
  2. Mechanism
    1. CGRP Antagonists block CGRP activity (vasodilator)
    2. CalcitoninGene-Related Peptide (CGRP) levels increases at Migraine Headache onset
      1. Vasodilator
      2. Pain sensitizer
  3. Preparations
    1. Erenumab (Aimovig) autoinjector
      1. Inject SQ once monthly in Abdomen, thigh, upper arm
    2. Ajovy (Fremanezumab)
      1. Three injections from prefilled syringes once every 3 months
    3. Emgality (Galcanezumab)
      1. Once monthly injection via pen
  4. Adverse Effects
    1. Injection site mild reactions
  5. Efficacy
    1. Reduces migraine Incidence by 2 fewer Migraine days/month
  6. Disadvantages
    1. Limited safety data outside healthy patients without comorbidity at time of 2018 release
    2. Expensive: $6900 per year
  7. References
    1. (2018) Presc Lett 25(8)
    2. (2018) Presc Lett 25(12): 70

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