Migraine Medication Telcagepant is Officially Dead

Last April I reported on Somebody Heal Me that drug manufacturer Merck was putting it's troubled migraine treatment medication telcagepant through another clinical safety study.

Merck had withdrawn its FDA application for telcagepant in 2009 after a previous safety study showed patients taking it experienced elevated liver enzymes. Now telcagepant is officially dead.

Merck announced quietly last week in it's quarterly earnings release that for the second time in two years it is dumping an acute migraine medication in development. (The other was MK-3207, which was also a CGRP receptor antagonist.) They did not specify precisely why they've given up on telcagepant, but it seems safe to assume it's related to the known issues with elevation of patient liver enzymes.

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Telcagepant is part of a category of new migraine medications called CGRP (calcium gene-related peptide) receptor antagonists. These medications respond to the discovery that many patients experience a rise in CGRP levels during a migraine attack. These drugs are thought to be safe for people with cardiovascular problems who cannot safely use triptans such as Imitrex or Treximet for migraine treatment. A big difference between triptans and CGRP receptor antagonists is that triptans target serotonin, while CGRP receptor antagonists target CGRP. It is thought that CGRP receptor antagonists will have less side effects than triptans, but given the concerns about elevated liver enzymes in telcagepant it is unknown whether this will bear out.

Boehringer Ingelheim is also developing a CGRP receptor antagonist. Their drug olcegepant is in Phase II of development in the United States and Europe. According to researchers, olcegepant has demonstrated the capacity to block release of CGRP in animal models.

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