Chronic migraine disorder, which a neurologist diagnosed [Michelle] Tracy with shortly after her initial ER visit, is defined as having 15 or more days with a headache that lasts four hours or more, in a given month.
In May 2018, the first drug in this class, Aimovig, was approved by the U.S. Food and Drug Administration (FDA) for episodic and chronic migraine. Brought to market by the pharmaceutical company Amgen, Aimovig is a calcitonin gene-related peptide (CGRP) inhibitor. It prevents migraines by stopping a protein fragment called CGRP — which is involved in the formation of migraine attacks — from binding to CGRP receptors in the brain, effectively blocking the migraine from developing.
Within the calendar year, two more CGRP inhibitors, one from the pharmaceutical company Teva and the other from Eli Lilly, were also approved by the FDA. All come in the form of monthly or quarterly injections that can be self-administered at home into the upper arm, stomach, or thigh.
CGRP inhibitors were a long time coming, and while they don’t work for everyone, they’ve had a significant impact. “It’s changed my practice,” says Dr. Stewart Tepper, a professor of Neurology at the Geisel School of Medicine at Dartmouth.
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