CGRP and migraine from a cardiovascular point of view: what do we expect from blocking CGRP?

J Headache Pain. 2019 Mar 12;20(1):27. doi: 10.1186/s10194-019-0979-y.

Abstract

Calcitonin gene-related peptide (CGRP) is a neuropeptide with a pivotal role in the pathophysiology of migraine. Blockade of CGRP is a new therapeutic target for patients with migraine. CGRP and its receptors are distributed not only in the central and peripheral nervous system but also in the cardiovascular system, both in blood vessels and in the heart. We reviewed the current evidence on the role of CGRP in the cardiovascular system in order to understand the possible short- and long-term effect of CGRP blockade with monoclonal antibodies in migraineurs.In physiological conditions, CGRP has important vasodilating effects and is thought to protect organs from ischemia. Despite the aforementioned cardiovascular implication, preventive treatment with CGRP antibodies has shown no relevant cardiovascular side effects. Results from long-term trials and from real life are now needed.

Keywords: CGRP; CGRP antibody; Cardiovascular; Migraine treatment.

Publication types

  • Review

MeSH terms

  • Antibodies, Monoclonal / therapeutic use*
  • Calcitonin Gene-Related Peptide / antagonists & inhibitors*
  • Calcitonin Gene-Related Peptide / physiology
  • Calcitonin Gene-Related Peptide Receptor Antagonists / therapeutic use*
  • Cardiovascular System / physiopathology
  • Humans
  • Migraine Disorders / drug therapy*
  • Migraine Disorders / etiology
  • Migraine Disorders / physiopathology
  • Receptors, Calcitonin Gene-Related Peptide / physiology
  • Sex Factors
  • Vasodilation / physiology

Substances

  • Antibodies, Monoclonal
  • Calcitonin Gene-Related Peptide Receptor Antagonists
  • Receptors, Calcitonin Gene-Related Peptide
  • Calcitonin Gene-Related Peptide