Is the new oral tablet Qulipta for the prevention of migraine as effective as injectable Aimovig, Ajovy, and Emgality?

Orange County Migraine & Headache Center

Results from clinical trials show high efficacy rates with Qulipta. Qulipta blocks the activity of CGRP as do the injectables. We have many patients who have switched to Qulipta and are doing as well or better than the injectable CGRP mAB’s. To see if Qulipta may be a good option for you, please set up an appointment with one of our providers.

 

To make an appointment, please call 949-861-8717.

Can I try one of the new CGRP monoclonal antibody injections if I am getting Botox every 12 weeks for my migraines? Botox helps but I would like to try one of these new CGRP injections and see if they can work together to better help with migraine prevention?

In the clinical trials with all three CGRP injections (Aimovig, Ajovy, Emgality) patients had to be off Botox for 4 months before receiving CGRP injections. This exclusion was not due to safety concerns; rather, the trials were designed to see how well migraines would respond to CGRP by itself or with an oral preventive and not while still receiving Botox. One of the concerns is that insurance companies may not approve both. Both are relatively expensive treatments. We have patients in our practice who are doing both but we are encouraging them to try CGRP by itself at some point as CGRP injections may work so well for migraine prevention that Botox is not needed. Fortunately, there are wonderful savings programs for all 3 CGRP injections for commercial insurance patients so now is a good time to set up an appointment and see what preventive regimen best for your migraines.

 

To make an appointment, please call 949-861-8717.

I have cluster headaches. Would any of the new CGRP monoclonal antibodies (CGRP mABs) work for cluster headache prevention?

Currently the only FDA approved indication for the CGRP mAB’s is for migraine prevention in adults. However, studies are underway for cluster headache prevention and the results look promising. In particular, Lilly recently completed a cluster headache trial with Emgality. For more details, go to https://migraineagain.com/emgality-cluster-migraine/ Non-CGRP treatment options include the relatively new GammaCore device. GammaCore is FDA approved for acute cluster headache treatment as well as an adjunctive treatment for cluster prevention. We have the device in our office and can arrange for a demonstration as part of an office visit.

To make an appointment, please call 949-861-8717.

What Is CGRP?

CGRP stands for Calcitonin Gene-Related Peptide.  It is a neuropeptide located in neurons (nerve cells) and smooth muscle throughout the part of the nervous system that is part of the migraine process. When a migraine trigger occurs in a susceptible individual, CGRP levels increase and this increase is felt to be major part of the pathophysiology of migraine. Research has demonstrated elevated CGRP during migraine attacks. In addition, research has demonstrated relief of a migraine attack when a CGRP blocking medication is given. This blocking of CGRP is the mechanism of action of the new category of CGRP Monoclonal Antibodies that are now coming to market for the prevention of migraine. The first one available, Aimovig, blocks CGRP activity at the receptor site. To learn more, go to www.Aimovig.com and www.scienceofmigraine.com

To find out if this new preventive treatment makes sense for you, please schedule a visit at our office. We are very excited about this new treatment.

To make an appointment, please call 949-861-8717.