Prophylaxie pharmacologique de la maladie migraineuse : quelles sont les avancées thérapeutiques ?

Migraine is a highly disabling neurological pain disorder for which management is frequently problematic. Most abortive and preventative treatments employed are classically non-specific and their efficacy and safety and tolerability are often unsatisfactory. Calcitonin gene-related peptide (CGRP) is recognized as crucial in the pathophysiology of migraine and new compounds that target the peptide have been increasingly explored in recent years. Monoclonal antibodies against CGRP (eptinezumab, fremanezumab, galcanezumab) or its receptor (erenumab) were subsequently developed. Phases 1 and 2 trials and preliminary results of phase 3 trials have shown a good safety/tolerability profile and efficacy in migraine prevention, especially in high frequent episodic and chronic forms. Long-term safety data are needed to determine whether these treatments represent a turning point for migraine prevention.