Ubrogepant: a new era in migraine treatment

Authors

  • Sangeeta Bhanwra Department of Pharmacology, Government Medical College and Hospital, Chandigarh, Punjab http://orcid.org/0000-0003-4344-6320
  • Kaza Ahluwalia Senior Drug Safety Physician, Parexel International, Chandigarh, Punjab

DOI:

https://doi.org/10.18203/2319-2003.ijbcp20201766

Keywords:

Ubrogepant, CGRP antagonist, Migraine

Abstract

Migraine is the most common neurological disorder that leads to incapacitating neurological symptoms. Acute attacks of migraine have been dealt with effectively with non-steroidal anti-inflammatory drugs (NSAIDs), ergot derivatives and triptans since long, but their use is limited by various adverse effects. Recent studies have shown that a neuropeptide, calcitonin gene related peptide (CGRP) plays a major role in pathophysiology of migraine by increasing the pain perception, both at the peripheral and central nervous system levels. So, in the last few years, some CGRP antagonists have found their way in the treatment of both episodic and chronic migraine. Ubrogepant is the first oral CGRP antagonist, that was approved by USFDA (United States food and drug administration) in December 2019, for the acute treatment of migraine with or without aura. It is more potent than the earlier CGRP receptor antagonists, has a good oral bioavailability and the risk of hepatotoxicity is also lesser than the previous Gepants.

Author Biographies

Sangeeta Bhanwra, Department of Pharmacology, Government Medical College and Hospital, Chandigarh, Punjab

 Associate Professor, Department of Pharmacology, Government Medical College & Hospital, Chandigarh.

Kaza Ahluwalia, Senior Drug Safety Physician, Parexel International, Chandigarh, Punjab

Senior Drug Safety Physician
Parexel International

References

Global Burden of Disease Study 2013 Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015;386(9995):743-800.

Saper J. Migraine research foundation. Available at: https://migraineresearchfoundation.org/about-migraine/migraine-in-women/. Accessed on 07 February 2020.

Edvinsson L. Role of CGRP in Migraine. Handb Exp Pharmacol. 2019;255:121-30.

Humphrey PP, Feniuk W, Perren MJ, Beresford IJ, Skingle M, Whalley ET, et al. Acad Sci. 1990;600:587-8.

Russo AF. Calcitonin gene-related peptide (CGRP): a new target for migraine. Annu Rev Pharmacol Toxicol. 2015;55:533-52.

Kahn J. FDA approves new treatment for adults with migraine. 2019 Available at: https://www.fda.gov/ news-events/press-announcements/fda-approves-new-treatment-adults-migraine. Accessed on 08 February 2020.

Villalon CM, Olesen J. The role of CGRP in the pathophysiology of migraine and efficacy of CGRP receptor antagonists as acute antimigraine drugs. Pharmacol Ther. 2009;124(3):309-23.

Ho TW, Edvinsson L, and Goadsby PJ. CGRP and its receptors provide new insights into migraine pathophysiology. Nat Rev Neurol. 2010;6(10):573-82.

Lassen LH, Haderslev PA, Jacobsen VB, Iversen HK, Sperling B, Olesen J. CGRP may play a causative role in migraine. Cephalalgia. 2002;22(1):54-61.

Scott LJ. Ubrogepant: First Approval [published online ahead of print, 2020 Feb 5]. Drugs. 2020;10:1007.

Moore E, Burgey CS, Fraley M. Characterization of ubrogepant: A potent and selective antagonist of the human calcitonin gene-related peptide receptor [abstract]. Neurology. 2019;92:10-21.

Allergan. Ubrogepant: Label-FDA [Internet]. 2019. Available at: https://www.accessdata.fda.gov/ drugsatfda_docs/label/2019/211765s000lbl. Accessed on 09 February 2020.

Dodick DW, Lipton RB, Ailani J. Ubrogepant for the Treatment of Migraine. N Engl J Med. 2019;381(23):2230-41.

Lipton RB, Dodick DW, Ailani J, Lu K, Finnegan M, Szegedi A, et al. Effect of Ubrogepant vs Placebo on Pain and the Most Bothersome Associated Symptom in the Acute Treatment of Migraine: The ACHIEVE II Randomized Clinical Trial. JAMA. 2019;322(19):1887-98.

Allergan. Safety, Tolerability and Drug Interaction Study of Ubrogepant with Erenumab or Galcanezumab in Participants with Migraine [Internet]. Available at: https://clinicaltrials.gov/ct2/ show/NCT04179474. Accessed on 09 February 2020.

Downloads

Published

2020-04-23

How to Cite

Bhanwra, S., & Ahluwalia, K. (2020). Ubrogepant: a new era in migraine treatment. International Journal of Basic & Clinical Pharmacology, 9(5), 819–821. https://doi.org/10.18203/2319-2003.ijbcp20201766

Issue

Section

Review Articles