New Migraine Meds in a New Year – and should I care?

Although I wouldn’t recommend that anyone pin all their hopes on the up-and-coming migraine medications, yes, there are some reasons why you should care about the new meds that are out, and the new ones we may see this year (and beyond).

So let’s take a quick look at what’s been happening:

Over the past few months, three medications have hit the market. All three are CGRP inhibitors, a new class of targeted migraine medication.

• Aimovig (erenumab) – self-injections once a month as a migraine preventative.
• Ajovy (fremanezumab) – self-injections either monthly or quarterly for migraine prevention. May also be useful for episodic cluster headache.
• Emgality (galcanezumab) – self-injections monthly. Has shown promise for both chronic and episodic migraine.

Yes, although all the same “class” of medication, each of these is different, with advantages and disadvantages. One may work where another may not. Readers may especially notice from the above list that Ajovy can be taken quarterly instead of monthly – that’s 8 few injections a year.

So what can we expect next from this class of medications? Here are three more that should hit the market in the months ahead:

• Ubrogepant – this one is an oral abortive – swallowed when needed to stop a migraine attack.
• Eptinezumab – self-injection, quarterly. Showing promise for chronic and episodic migraine. Already being promoted as a very “fast acting” option.
• Rimegepant – oral medication, used either as an abortive or a preventative.

A lot of the differences between these medications aren’t listed above – and some will vary from patient to patient. However, notice that now we have more oral options, and more abortives (taken when the attack hits). So those who hate injections (even though injection technology is improving quickly, and is not as bad as it once was) have hope.

What else does this mean, besides the fact that one may work and one may not for you?

A lot of people are speculating what this will mean for price. At the moment, each of these are similarly priced. However, at the very least, it’s important to be aware of the special programs each of company will put in place, and how they will change. Especially early on, these companies will want to gain customers. There are ways to save money.

Also, these companies will want to promote what they see as benefits of their particular brand – so watch for that. Also, many are trying to gain customer loyalty by providing other services, such as helpful info or apps for your phone. Watch for that as well.

As we’ve talked about before, even as new anti-CGRP meds flood the market, a whole new class beyond that is being developed. Though not expected anytime soon, watch for news about:

• ALD1910 – being developed by Alder Pharmaceuticals (developers of eptinezumab) as a migraine preventative.
• AMG 301 – being developed by Amgen/Novartis (makers of Aimovig) as a migraine preventative.

For another perspective on the class of migraine drugs currently hitting the market, see A Crowded Field for Migraine Therapies, Where Recently There Were None.