| REVIEW ARTICLE |
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| Year : 2021 | Volume
: 69
| Issue : 7 | Page : 98--104 |
Emerging Targets for Migraine Treatment
David Moreno-Ajona1, María Dolores Villar-Martínez1, Peter James Goadsby2
1 Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
2 NIHR-Wellcome Trust King's Clinical Research Facility/SLaM Biomedical Research Centre, King's College Hospital, London, United Kingdom; Department of Neurology, University of California, Los Angeles, Los Angeles CA USA
Correspondence Address:
Dr. Peter James Goadsby
Wellcome Foundation Building, King's College Hospital, London SE5 9PJ
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0028-3886.315989
Background: While understanding the pathophysiology of migraine has led to CGRP-based treatments, other potential targets have also been implicated in migraine.
Objectives: To catalog new promising targets for the treatment of migraine.
Methods: We completed a literature review focusing on 5HT1F, PACAP, melatonin, and orexins.
Results: The 5HT1F receptor agonist lasmiditan, following two positive randomized placebo-controlled trials, was FDA-approved for the acute treatment of migraine. PACAP-38 has shown analogous evidence to what was obtained for CGRP with its localization in key structures, provocation tests, and positive studies when antagonizing its receptor in animal models, although a PAC-1 receptor monoclonal antibody study was negative. Melatonin has undergone several randomized controlled trials showing a positive trend. Filorexant is the only dual orexin receptor antagonist, which was tested in humans with negative results.
Conclusions: Further and ongoing studies will determine the utility of these new therapies with lasmiditan and melatonin having demonstrated efficacy for the treatment of migraine.
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