What Is Surprising Us About The New CGRP Preventatives?
Can you believe it? It was in the spring of 2018 that Aimovig (erenumab) was approved in the USA. My! Time flies!
Really, all the CGRP related drugs are still extremely new, when it comes to prescription drugs for migraine. Long term trials are still a future hope. And we’re just starting to guess at some trends that we may be seeing from patients.
But what are some of the trends we’re seeing? Let’s take a moment to talk about them, and you can comment if you’ve had a similar of very different experience.
(1) For many, these drugs are working better than expected!
First, the (very) good news. For many patients, these CGRP inhibitors are working better than the clinical trials even led us to believe.
As drug companies rush to market new migraine drugs, we expect to see headlines that use phrases such as “life-changing!”. But in the case of drugs like Avojy and Aimovig, this does seem to be the case with many patients – a very significant improvement in their symptoms.
And these are not always “just any” patient. These are patients who have not had a lot of success with other medications.
So there are good reasons to have a lot of hope that these new drugs will help many more people around the world in the next few years.
(2) Sometimes these drugs are less effective after a while.
This is a biggie. Reports are coming in that, for many patients, the benefits tend to “wear off” after a while.
Will switching to another CGRP preventative help? It’s very possible, and it’s not at all a surprise that you may need to try more than one before you find the right fit.
But this is one that researchers are going to pay a lot of attention to in the next few years. Which patients are having this issue, and why? Will some CGRP preventatives work better than others? Even if they’re not as beneficial as they were in the first few weeks, do they still provide significant benefit? What’s your experience?
(3) Side Effects
Any surprises with side effects? Side effects are not a huge problem for many patients, but it is starting to sound like constipation is an issue for some, especially with Aimovig (and in this case, switching may provide significant benefit). It seems that it may be more likely to make constipation issues worse if you already have a pre-existing condition.
In a recent discussion published in The American Journal of Managed Care, two neurologists pointed out some of the other side effects they’re seeing – “. . . a worsening of Reynaud syndrome, fatigue, hair loss, sexual dysfunction, and in women, some reports of irregular menstrual periods.”
Again, discussing side effects shouldn’t make it sound like patients are running away from these medications in droves because they’re all having major problems. Side effects may be rare, but we have to keep an eye on them because certain patients may be more prone to certain side effects than others.
If you’ve been taking a new preventative, such as Vyepti, Aimovig, Ajovy, or Emgality, how long have you been on it? What has your experience been? Anything you might share could be a help for our community.