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New Migraine Drug Promising

May Help Patients Who Don’t Respond to Triptans
By Kathleen Doheny
WebMD Health News
Reviewed by Louise Chang, MD

June 7, 2007 - New migraine pain relief may be on the way for the 28 million American sufferers, shows a promising new study.

A new migraine drug under study that works differently than medications currently on the market provided pain relief for more than two-thirds of those who tried it, says Tony Ho, MD, senior director of clinical neuroscience at Merck Research Laboratories in North Wales, Pa., who presented the findings at this week's annual meeting of the American Headache Society in Chicago.

"It also had a very good duration of action," he tells WebMD. "This effect lasted over 24 hours."

The new drug, for now called MK-0974, may eventually help the 30% of migraine sufferers who don't get relief from -- or can't take -- triptans, a current mainstay of migraine treatment to stop migraine pain and disability.

Other experts not involved in the study agreed the new drug looks promising. It's not expected on the market, however, until at least 2009.

MK-0974 in a New Class

MK-0974 is one of a new type of medications with a tongue-twisting name: It's an oral calcitonin-gene-related peptide receptor antagonist, or CGRP receptor antagonist.

CGRP is a type of brain chemical called a peptide that experts now know plays a role in migraines. ''The CGRP peptide was discovered in 1982, and in the early 1990s researchers started speculating about its role," Ho says.

Experts know that CGRP levels are elevated during a migraine. And in studies, when CGRP is given to migraine sufferers, it can produce a migraine headache, Ho says.

"When the neuropeptide CGRP gets released, the migraine pain gets worse," Ho tells WebMD. "We think it's involved in the majority of patients."

The new drug works by blocking CGRP. Triptans, in contrast, work on another brain chemical called serotonin. Triptan-type migraine medications constrict blood vessels during a migraine and help relieve related migraine symptoms including pain. However, because of their effects on blood vessels, triptans can't be taken by those who have had heart disease and certain other health problems.

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