Why Some CGRPs Work When Others Don't
Last updated: June 2023
By now, most people in the migraine community have heard of, if not tried, the CGRPs – a new approach in the prevention and treatment of migraine. After a bit of a drought in the development of effective medications for this prevalent condition, many migraineurs were lined up and chomping at the bit to see what all the hubbub was about. And there was quite a lot of buzz about this new treatment. The positive results from the trials were rumored to be significant and potentially life-changing.
A recurring question about CGRPs
It’s now been two years since the three variations of the CGRPs were introduced (Aimovig, Ajovy, and Emgality) and beyond the troubling stumbling block related to its high expense, one major question seems to keep reemerging: “Why does this treatment work so well for some and not others?”
They don't work for everyone
Why not me? With hopes raised high by the success stories of others, many of our community members expressed disappointment after trying one of the CGRPs to no avail. Such a normal response to be let down after hearing about the dramatic improvement of others when you don’t achieve a similar outcome.
If at first you don’t succeed, try, try again. However, we have learned that not all CGRPs operate in the same way. So, if one of the three CGRPs is ineffective, it doesn’t necessarily mean that another will not work.
What are CGRPs?
CGRP is a protein that is found throughout the brain and body which is highly prevalent in the sensory nerves that supply the head and neck. Researchers discovered CGRP is found in high levels in migraine sufferers during attacks. These treatments basically block that protein, however they do so in different ways.
Different approaches to treatment
In order to make the highly scientific more understandable, the approach of the CGRP treatment has been described using a lock and key analogy. Emgality and Ajovy attach to the CGRP protein (the key), while Aimovig works differently by blocking the CGRP receptor (the lock). So while all three drugs are focused on the same challenge, they use a different target to reach their goal.
What does this mean for you?
This can mean that if Aimovig doesn’t work for you, Emgality or Ajovy might. With the CGRP treatments, it is definitely worth trying a couple of them before throwing in the towel.
One size does not fit all with migraine
Of course, there’s also the potential outcome that none of the CGRP treatments will work for you. Or that, rather than stopping your attacks dramatically and entirely, this treatment may improve your condition just slightly. Migraine works so differently in all of us so that what is an effective strategy for one person can be completely ineffective for another.
A multipronged approach
For most migraineurs, there is no such thing as a simple cure or easy fix. Rather, the most effective strategy is a multipronged one, involving multiple approaches which include various medications and countless life alterations (diet, sleep, and exercise) that, coupled together with time, effort, energy, and lots of patience, will result in a gradual improvement in this complex neurological condition that is migraine.
Have you tried one or more of the CGRPs? What has been your experience? Did one work better than another? Please share your experience in the comment section below so that we may learn from one another.
How many medications do you take to manage your chronic migraines?