Understanding medications limitations is very important. When migraines medications fail the fastest relief can be obtained by SASPGB or Self-Administered Sphenopalatine Ganglion Blocks. Visit www.SphenopalatineGanglionBlocks.com to learn more.
CGRP medications or calcitonin gene-related peptide inhibitors Monoclonal antibodies target either CGRP or the CGRP receptor and are used for Migraine Prevention. There are two types CGRP medications: The following monoclonal antibody CGRP inhibitors have been approved:
Aimovig (erenumab-aooe): Approved May 17, 2018
Ajovy (fremanezumab): Approved Sept 14, 2018
Emgality (galcanezumab-gnlm): Approved Sept 27, 2018
Vyepti (eptinezumab-jjmr): Approved Feb 21, 2020.
A new article “Real-world effectiveness and safety of erenumab for the treatment of migraine: A systematic review and meta-analysis” published in Eur J Pharmacol
. 2024 May discusses effectiveness. Effectiveness is far lower than you might suspect and was reported as: “The MMD/MHD response rates revealed that approximately one-third of patients exhibited a response greater than 30%, while one-sixth demonstrated a response exceeding 50%.”
Reading the conclusion of the article only would lead both patients and clinicians to believe these drugs are far more effective than results of 53 studies actually showed. “Conclusion: This study provides strong evidence of the effectiveness and safety of erenumab in the real world; to our knowledge, this is the first real-world meta-analysis specific to erenumab. Erenumab represents a solid therapeutic option for physicians.”
This is not to say these are not useful drugs.
Gepants are block the CGRP receptor and are effective at both relieving migraines and preventing them.
Ubrelvy (ubrogepant): Approved Dec 23, 2019
Nurtec ODT (rimegepant sulfate): Approved Feb 27, 2020.
Qulipta (atogepant): Approved Sept 28, 2021
Zavzpret (zavegepant) (intranasal/oral): Approved March 10, 2023.
The good news is that SASPGb /SPG Blocks are safe to utilize with both CGRP antibodies and Gepants! Acute Migraine Pain: CGRP Preventives are patially effective for many patients. Fastest Relief is SASPGB which can give almost instant relief!