CGRP: Poetry of Hope

The new CGRP antagonist medications that are currently in clinical trials are once again in the news, leading to lots of Facebook posts and tagged shares of the “Maybe this will help you!” type. Normally I am automatically defensive about such posts since they are often about the daith piercing, or turmeric, or some other unlikely (and insulting) remedy. But not this time. Yes, there are concerns: at least a year until FDA approval; and the expense, which is likely to be very high. But since this is the FIRST preventative medication specifically developed for migraine, and trials have shown few side effects and a high rate of improvement among chronic and episodic sufferers, including myself personally in both my trials, the hope I’ve been feeling has lately given way to almost a giddiness, aided by the fact that I’m now in my eighth week of unprecedented lack of head pain. Technically, right now I am no longer chronic. I picked up my box of Sumatriptan and it’s been in my medicine cabinet for a week, unopened.

While sitting here waiting for the other shoe to drop, as it always has (though I haven’t felt this good since college), I wrote a poem. Yes, a CGRP poem.

Calcitonin
Gene-Related Peptide.
Pharmaceutical studies
Clinical trials
For the lucky.
Somehow that
Includes me.
Amgen double blind
Monthly injections of
Saline placebo
Or actual medicine.
Then open label,
Meaning medicine every time.
And my life, so much of which
Was spent in bed
In pain
Was returned to me.

One study led to another.
The new trial, looser rules
Analyzing effective dosages.
The prick, the burn
The slow seeping of
Magic medicine
Into my muscles, my
Capillaries
A subtle fluttering of
Miracle wings
Rising to my head.
My neck tingles.
My sensitive, tender brain
Coated and soothed
By monoclonal antibodies
Which confound and confuse me.
I don’t understand
How the different drugs work,
Exactly what they do,
All the ways in which they help.
I just know that the serum
Surges into my body
And provides protection
That I can feel.

When I receive an injection
While having head pain
It seems to lift up
And resettle, quieter,
Even though the medicine
Is supposed to be preventative,
Not for acute pain.
This drug, in all its forms
May be the miracle
We’ve been waiting for
Not, of course, a cure
But the closest any of us
Has ever seen.

Calcitonin
Gene-Related Peptide
Is an amino acid released
When a migraine occurs.
Our good friends
Botox, and the Triptans,
May coincidentally help
To prevent our neurons
From producing CGRP
During a migraine’s genesis.
CGRP’s only function
Is to cause pain.
The little bit I’ve learned
Is that the new medicines being tested
Are deliberate antagonists,
Developed specifically
To target and stop
The production of CGRP.
And they work.

Of course there are negatives.
There always are.
The expense; the necessity
Of needing to receive injections
In a doctor’s office
Instead of popping a pill,
Conveniently, at home.
But.
The amazing fact of a drug –
The FIRST drug!
Designed just for the prevention
Of migraine
With very few side effects
When we’ve been taking
Medicines for depression,
Seizures, blood pressure, heart issues
Many of which cause problems worse
Than the migraine itself.
The process, the trial and error…
So much of it error.

Calcitonin
Gene-Related Peptide.
The pain-causing mechanism
Prompted by our brains’
Over-sensitivity
Halted.
We’ve been hoping for
This medication
Our whole lives.
We don’t have
Too much longer to wait.
For many of us,
Finally,
Everything
Is going to change.

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