New Migraine treatment discovered at King’s College London

A new preventative treatment is now available for the most common and disabling neurological disorder in the UK – Migraine.

A new preventive treatment has been developed for the most common and disabling neurological disorder in the UK – Migraine. After completing clinical trials conducted in 2017, the drug – Erenumab is now available for purchase within the UK market.

Professor Peter Goadsby, Professor of Neurology, King's College London and Director at Wellcome Trust Clinical Research Facility at King's College Hospital, and Professor Lars Edvisson, Professor of Medicine at the University of Lund, Sweden discovered a new preventative treatment that could transform patient care and improve quality of life
by significantly reducing the number of migraine episodes patients experience.

What is migraine?

Migraine is one of the most common neurological conditions that affect our population. Not only do people with this condition suffer from severe headache and throbbing pain - they may also experience nausea, vomiting and increased sensitivity to light and sound.

Migraine is ranked globally as the second most disabling disease, and is the leading cause of disability among all neurological disorders.

Data from The Migraine Trust estimates that the UK population loses 25 million days from work or school each year from this condition which is calculated to a cost of £2.25 billion per year.

What is the new treatment available for migraine and how does it work?

Calcitonin gene-related peptide (CGRP) plays an essential role in migraine.

It affects patients by modifying the transmission of pain signals in brain systems involved in migraine. During spontaneous migraine attacks GCRP is released from the trigeminal nerve, which is responsible for pain experienced in the head.

The role of GCRP was discovered during experiments performed in the laboratory by Professor Peter Goadsby and Professor Lars Edvinsson. During experiments they found that an electrical activation of the trigeminal nerve – an essential pathway for migraine – leads to an increase of GCRP in blood.

These findings were then transferred into further studies which showed that GCRP concentration is increased in peripheral blood during spontaneous migraine attacks but normalise after effective attack treatment.

Based on their studies, several medicinal approaches were developed by Professor Goadsby and Professor Edvisson to interact with this pathway. Initial developments focused on creating the drug - Erenumab that blocks the action of CGRP receptors.

There are several substances that have been created based on this method that are still under investigation in clinical trials hosted by King’s Health Partners today. 

Recently there have been additional treatments developed to help patients that suffer from migraine that have proven to be effective preventives of attacks. These monoclonal antibodies - a single clone of cells producing  identical antibody molecules – is the first preventive treatment that has been specifically developed for migraine and is now used within headache clinics at King’s College Hospital and Guy’s and St Thomas’ NHS Foundation Trusts.

How will this improve patient care?

The preventive treatment with monoclonal antibodies against the CGRP receptor, which will require the patient to be treated only once every four weeks, will significantly reduce the number of migraine days patients suffer on a monthly basis.

Patients suffering from migraine often experience a substantial reduction in their quality of life. Beyond their constant headache, those suffering from this condition may also have to deal with multiple disruptions from daily activities with symptoms often lasting for days.

The new treatment eliminates disruption allowing a positive continuity within patient daily lives.

Are there any side effects of calcitonin gene-related peptide blockers?

The research has shown this treatment has a low side-effect profile, meaning it is a treatment that does not disrupt a patient’s life.

What are the plans to take this treatment forward?

Currently this preventive treatment is offered to patients who suffer from severe migraines and have not had any success in reducing their symptoms from other types of medication. As with any discovery of a new treatment there is a lengthy process to comply with that needs to be addressed in the near future.

Research also continues in many other avenues to discover why this treatment is successful. Some of the questions to provide robust answers for are ‘what is the molecular basis that differentiates the patient that does or does not respond to this treatment’.

These findings can help develop a migraine treatment that works for everyone.

King’s Health Partners Neurosciences has an ambitious vision to use our collective clinical, research, and educational expertise to deliver world-class patient care and research.