The annual scientific meeting was held last weekend in Philadelphia. The largest number of presentations was about the CGRP drugs, both monoclonal antibodies (mAbs) for the prevention and soon to be approved oral medications for the abortive treatment of migraine attacks. In addition to the three currently available mAbs, erenumab (Aimovig), fremanezumab (Ajovy), and galcanezumab (Emgality), which are self-injected subcutaneously every month (Ajovy can be given every 3 months), a fourth intravenous mAb, eptinezumab, which is given every 3 month, is likely to come out early next year.
Two oral CGRP drugs that are in development are taken as needed for an individual attack of migraine. These drugs are rimegepant and ubrogepant and they are expected to be approved by the FDA in about 6 months.
One interesting presentation by N. George and Z. Ahmed from the Cleveland Clinic and other Cleveland hospitals described 8 patients with trigeminal neuralgia (TN) who also suffered from migraines and were given injections of erenumab (Aimovig). Six out of 8 reported good relief of their neuralgia along with migraines. It is possible that the neuralgia pain was part of their migraine, but it may still be worth trying erenumab in patients with TN who do not respond to standard therapies or Botox.
