CGRP for Migraine: Setting the Right Expectations

During the 60th Annual American Headache Society (AHS) Scientific Conference in San Francisco, I had the distinct pleasure of sitting down with Dr. David Dodick, professor of neurology and a headache specialist at the Mayo Clinic in Phoenix, Arizona. Dr. Dodick is the Medical Director of the Headache Program as well as the Concussion Program. He is a past president of AHS and of the International Headache Society. Dr. Dodick has authored more than 280 peer-reviewed publications and co-authored 8 books.

Dr. Dodick has been highly involved in the research and clinical trials of Calcitonin Gene-Related Peptide (CGRP) inhibitors, the first class of medications developed specifically made for the prevention of migraine.

CGRPs - are they really game-changers?

With much fanfare surrounding CGRP inhibitors, I felt that it was important to ask Dr. Dodick about setting expectations. While trial results have been very promising, this will not work for everyone. There is still no cure for migraine. In this video, he shares the discussion that he has with his own patients.

CGRP clinical trial results

“The way we define clinical response is going to be different than in clinical trials and it’s going to be the patient who defines whether or not he or she is responding.”

A patient trying the first CGRP inhibitor has a 1 in 5 chance of not responding at all, but “the good news is that there is more coming.”

Optimistic about the future of migraine treatments

Dr. Dodick admits that he also has to set his own expectations of how his patients are going to respond. Truly an optimist, he’s disappointed that a patient doesn’t have more relief based on the clinical trial criteria. But for a patient who experiences a decrease in the average severity of their migraine, this can be truly life-changing. “I have to adjust my expectations because patients are grateful for anything you can do for them.”

“I’m excited. I’ve never been more excited.” Dr. Dodick concludes that the future has never looked brighter.

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