Antibodi Monoklonal terhadap CGRP sebagai Terapi Preventif Migraine

Oleh :

dr. Andriani Putri Bestari, Sp.S

Antibodi monoklonal terhadap calcitonin gene-related peptide (CGRP) diduga bermanfaat dalam pencegahan migraine. Migraine merupakan penyakit serebral yang memiliki gejala mengganggu (termasuk nyeri kepala), banyak ditemui di praktik, dan berdampak pada kualitas hidup pasien. Penelitian telah menekankan pentingnya peran CGRP dalam patofisiologi migraine, sehingga terapi yang menyasar CGRP dianggap akan bermanfaat mencegah migraine.[1]

Peran CGRP dalam Patofisiologi Migraine

Patofisiologi migraine merupakan proses yang kompleks dan multifaktorial. Salah satu proses patofisiologi yang dikenal adalah proses cortical spreading depression (CSD). CSD adalah gelombang depolarisasi neuron yang menyebar secara perlahan (2-6 mm/menit) yang diikuti oleh supresi neuron yang bertahan lebih lama. CSD merupakan proses yang diduga menyebabkan aura pada migraine.

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Referensi

1. Mitsikostas DD, Reuter U. Calcitonin gene-related peptide monoclonal antibodies for migraine prevention: comparisons across randomized controlled studies. Current opinion in neurology. 2017 Jun 1;30(3):272-80.
2. Bigal ME, Walter S. Monoclonal antibodies for migraine: preventing calcitonin gene-related peptide activity. CNS drugs. 2014 May 1;28(5):389-99.
3. Tso AR, Goadsby PJ. Anti-CGRP monoclonal antibodies: the next era of migraine prevention?. Current treatment options in neurology. 2017 Aug 1;19(8):27.
4. Dodick DW. CGRP ligand and receptor monoclonal antibodies for migraine prevention: Evidence review and clinical implications. Cephalalgia. 2019 Mar;39(3):445-58.
5. Levin M, Silberstein SD, Gilbert R, Lucas S, Munsie L, Garrelts A, Kennedy K, Everman N, Pearlman E. Basic considerations for the use of monoclonal antibodies in migraine. Headache: The Journal of Head and Face Pain. 2018 Nov;58(10):1689-96.
6. Alpuente A, Torre-Sune A, Caronna E, et al. Impact of anti-CGRP monoclonal antibodies on migraine attack accompanying symptoms: A real-world evidence study. Cephalalgia. 2023 Aug;43(8):3331024231177636. doi: 10.1177/03331024231177636.
7. Pellesi L, Guerzoni S, Pini LA. Spotlight on anti‐CGRP monoclonal antibodies in migraine: The clinical evidence to date. Clinical pharmacology in drug development. 2017 Nov;6(6):534-47.
8. Scuteri D, Adornetto A, Rombolà L, Naturale MD, Morrone LA, Bagetta G, Tonin P, Corasaniti MT. New Trends in Migraine Pharmacology: Targeting Calcitonin Gene–Related Peptide (CGRP) With Monoclonal Antibodies. Frontiers in pharmacology. 2019;10.
9. Israel H, Neeb L, Reuter U. CGRP monoclonal antibodies for the preventative treatment of migraine. Current pain and headache reports. 2018 May 1;22(5):38.
10. Dodick DW, Goadsby PJ, Spierings EL, Scherer JC, Sweeney SP, Grayzel DS. Safety and efficacy of LY2951742, a monoclonal antibody to calcitonin gene-related peptide, for the prevention of migraine: a phase 2, randomised, double-blind, placebo-controlled study. The Lancet Neurology. 2014 Sep 1;13(9):885-92.
11. Ford JH, Ayer DW, Zhang Q, Carter JN, Leroux E, Skljarevski V, Aurora SK, Tockhorn-Heidenreich A, Lipton RB. Two randomized migraine studies of galcanezumab: Effects on patient functioning and disability. Neurology. 2019 Jul 30;93(5):e508-17.
12. Sacco S, Bendtsen L, Ashina M, Reuter U, Terwindt G, Mitsikostas DD, Martelletti P. European headache federation guideline on the use of monoclonal antibodies acting on the calcitonin gene related peptide or its receptor for migraine prevention. The journal of headache and pain. 2019 Dec;20(1):6.
13. American Headache Society. The American Headache Society position statement on integrating new migraine treatments into clinical practice. Headache: The Journal of Head and Face Pain. 2019 Jan;59(1):1-8