CGRP and migraine from a cardiovascular point of view: what do we expect from blocking CGRP?

Valentina Favoni†Email author View ORCID ID profile,
Luca Giani†,
Linda Al-Hassany†,
Gian Maria Asioli†,
Calogera Butera†,
Irene de Boer†,
Martina Guglielmetti†,
Chrysoula Koniari†,
Theodoros Mavridis†,
Marge Vaikjärv†,
Iris Verhagen†,
Angela Verzina†,
Bart Zick†,
Paolo Martelletti†,
Simona Sacco† and
European Headache Federation School of Advanced Studies (EHF-SAS)

†Contributed equally

The Journal of Headache and PainOfficial Journal of the "European Headache Federation" and of "Lifting The Burden - The Global Campaign against Headache"201920:27

https://doi.org/10.1186/s10194-019-0979-y

Received: 11 December 2018
Accepted: 26 February 2019
Published: 12 March 2019

Abstract

Calcitonin gene-related peptide (CGRP) is a neuropeptide with a pivotal role in the pathophysiology of migraine. Blockade of CGRP is a new therapeutic target for patients with migraine. CGRP and its receptors are distributed not only in the central and peripheral nervous system but also in the cardiovascular system, both in blood vessels and in the heart. We reviewed the current evidence on the role of CGRP in the cardiovascular system in order to understand the possible short- and long-term effect of CGRP blockade with monoclonal antibodies in migraineurs.

In physiological conditions, CGRP has important vasodilating effects and is thought to protect organs from ischemia. Despite the aforementioned cardiovascular implication, preventive treatment with CGRP antibodies has shown no relevant cardiovascular side effects. Results from long-term trials and from real life are now needed.