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Papers of the Week

Papers: 29 Apr 2023 - 5 May 2023


Human Studies, Molecular/Cellular, Neurobiology

Migraine/Headache, Psychological/Comorbidities

2023 May 01

Rev Neurol




[Cardiovascular safety of new drugs for the acute and preventive treatment of migraine: gepants and ditans].


Pérez-Rodríguez A, Bandrés-Hernández P, Anciones C, Terrón-Cuadrado C, Canuet-Delis L, Gilo-Arrojo F, Anciones B


Migraine is a prevalent neurological condition characterised by disabling headache attacks. In recent decades, new drugs have been developed specifically for the acute and preventive treatment of migraine based on its pathophysiology. These include calcitonin gene-related peptide (CGRP) antagonists (CGRP) (gepants) and selective serotoninergic 5-HT1F receptor agonists (ditans). CGRP is a neuropeptide released by trigeminal terminals that acts as a vasodilator, causes neurogenic inflammation and thus generates pain and sensitisation in migraine. It also has a powerful vasodilatory action and is involved in cardiovascular regulation, which is why numerous studies are under way to assess the vascular safety of acting against CGRP. The high selectivity of ditans for the serotoninergic 5-HT1F receptor with a low affinity for other serotoninergic receptors seems to translate into little or no vasoconstrictor effect, which is mediated by the activation of 5-HT1B receptors.