Calcitonin Gene–Related Peptide Receptor Antagonist BIBN 4096 BS for the Acute Treatment of Migraine

• Published in: The New England journal of medicine Vol. 350; no. 11; pp. 1104 - 1110
• Main Authors: Olesen, Jes, Diener, Hans-Christoph, Husstedt, Ingo W, Goadsby, Peter J, Hall, David, Meier, Ulrich, Pollentier, Stephane, Lesko, Lynna M
• Format: Journal Article
• Language: English
• Published: Boston, MA Massachusetts Medical Society 11.03.2004
• Subjects: Acute Disease; Adult; Biological and medical sciences; Calcitonin Gene-Related Peptide Receptor Antagonists; Clinical outcomes; Dose-Response Relationship, Drug; Double-Blind Method; Drug therapy; Female; General aspects; Humans; Male; Medical sciences; Medical treatment; Middle Aged; Migraine; Migraine Disorders - drug therapy; Neurology; Piperazines; Piperidines - adverse effects; Piperidines - therapeutic use; Quinazolines - adverse effects; Quinazolines - therapeutic use; Time Factors; Vascular diseases and vascular malformations of the nervous system; Nervous system diseases; Acute; Migraine; Cardiovascular disease; Calcitonin gene related peptide; Cerebral disorder; Vascular disease; Medicine; Pain; Treatment; Central nervous system disease; Antagonist; Cerebrovascular disease; Biological receptor
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJMoa030505

Calcitonin gene–related peptide (CGRP) dilates cerebral and dural vessels and may contribute to migraine, since cranial CGRP levels have been shown to be elevated in patients with migraine. In this randomized, controlled trial, patients with migraine had a higher rate of response to the CGRP-receptor antagonist BIBN 4096 BS than to placebo (66 percent vs. 27 percent). A proof-of-concept study of a CGRP-receptor antagonist as an effective acute treatment for migraine. Migraine is among the most common disorders, with a one-year prevalence of 12 percent. 1 , 2 According to the Global Burden of Disease Study conducted under the auspices of the World Health Organization, migraine is one of the leading causes of disability. 3 Although the availability of triptans — selective agonists of serotonin (5-hydroxytryptamine [5-HT]) receptors that activate 5-HT 1B and 5-HT 1D (5-HT 1B/1D ) receptors — has greatly improved the acute treatment of migraine, many patients have no response to triptans, complete pain relief is the exception rather than the rule, and their vasoconstrictive properties cause concern among doctors and . . .