Pharm

Calcitonin Gene-Related Peptide Blocker

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Calcitonin Gene-Related Peptide Blocker, CGRP Antagonist, Erenumab, Ajovy, Fremanezumab, Emgality, Galcanezumab, Aimovig

  • Indications
  1. Migraine Prophylaxis if refractory to first-line agents
  • Mechanism
  1. CGRP Antagonists block CGRP activity (vasodilator)
  2. Calcitonin Gene-Related Peptide (CGRP) levels increases at Migraine Headache onset
    1. Vasodilator
    2. Pain sensitizer
  • 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
  • Adverse Effects
  1. Injection site mild reactions
  • Efficacy
  1. Reduces migraine Incidence by 2 fewer Migraine days/month
  • Disadvantages
  1. Limited safety data outside healthy patients without comorbidity at time of 2018 release
  2. Expensive: $6900 per year
  • References
  1. (2018) Presc Lett 25(8)
  2. (2018) Presc Lett 25(12): 70