Are indirect comparisons for treatments in migraine necessitas? Many inevitable challenges to overcome

Review Clinical Neurology

Shared and independent roles of CGRP and PACAP in migraine pathophysiology

Adisa Kuburas et al.

Summary: The neuropeptides CGRP and PACAP play important roles in migraine pathogenesis by causing vasodilation and migraine-like symptoms. They have similarities in their clinical and preclinical actions, but also notable differences, such as PACAP causing premonitory-like symptoms and CGRP and PACAP being found in different ganglia. Both peptides cause similar migraine-like symptoms in rodents, but may act through independent mechanisms. The existence of multiple receptors for CGRP and PACAP further complicates the signaling pathways involved, suggesting that targeting PACAP receptors could complement current CGRP-based migraine therapeutics.

JOURNAL OF HEADACHE AND PAIN (2023)

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Review Anesthesiology

Different routes of administration in chronic migraine prevention lead to different placebo responses: a meta-analysis

Diego Belandrino Swerts et al.

Summary: Placebo response is a significant determinant of health outcomes in various disorders. This study examines how different administration routes affect the placebo response in chronic migraine patients. The results show that head injection has the strongest placebo response, while oral and subcutaneous administration have lower effects.

PAIN (2022)

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Review Pharmacology & Pharmacy

Novel synthetic treatment options for migraine

Andrea Negro et al.

Summary: Migraine is a common neurological disorder, and triptans are considered the standard of care for acute treatment. However, new medications such as ditans and gepants have been developed for migraine-specific treatment with improved tolerability and safety. Further studies are needed to evaluate the efficacy and safety of these new medications compared to established treatments.

EXPERT OPINION ON PHARMACOTHERAPY (2021)

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Review Clinical Neurology

Anti-CGRP monoclonal antibodies for migraine prevention: A systematic review and likelihood to help or harm analysis

Konstantina Drellia et al.

Summary: The study found that anti-CGRP mAbs have a more favorable benefit-risk ratio for the prevention of episodic and chronic migraine compared to established treatments, but head-to-head studies are needed to confirm these results.

CEPHALALGIA (2021)

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Article Clinical Neurology