New Neuropeptide for Migraine prevention.

Lu AG09222 is a monoclonal antibody which targets pituitary adenylate-cyclase-activating polypeptide (PACAP). This antibody  provides migraine prevention.

Migraine affects 25% of women and 6% of men and is a chronic, genetically inherited neurological disorder. Migraine is the most common medical condition for women. Migraine affects school, work, and past time activities and commonly is a disabling condition.

This is an article by Britt Talley Daniel MD, retired member of the American Academy of Neurology, Migraine textbook author, Podcaster, YouTube video producer, and Blogger.

 What is PACAP

PACAP is a neuropeptide that is important in various biological processes important to Migraine, including vasodilation, neuroinflammation, and pain transmission. It is found in central and peripheral nervous systems. Current research has found that PACAP is a key player in migraine pathophysiology.

PACAP levels rise during migraine attacks. PACAP infusion triggers migraine attacks in susceptible migraine individuals. The migraine process causes arterial vasodilation and the release of pain releasing neurochemicals, CGRP, Neurokinin, and Substance P

Lu AG09222 causes vasodilation and modulates pain. It has been tried for migraine prevention in a recent study, It’s ability to affect PACAP makes it a compelling therapeutic intervention.

 How can Lu AG0922 help Migraine

Lu AG09222 binds to PACAP and prevents its interaction with receptors involved in the migraine cascade. This targeted approach has the potential to halt migraine progression.

Early-phase clinical trials of Lu AG09222 have shown encouraging results. Key findings are that it is safe with minimal side effects and well-tolerated.

It worked. Patients receiving the monoclonal antibody reported a significant reduction in migraine days compared to placebo.

Lu AG09222 is durable and persists over extended periods, making it a potentially convenient option for long-term management.

These results look to the promise of Lu AG09222 as a preventive therapy for Migraine. Ongoing trials are expected to provide further insights into its optimal dosing, long-term safety, and efficacy across different patient populations.

Possible advantages of Lu AG09222

There may be an improved quality of life using Lu AG09222 if it reduces the frequency and severity of migraine attacks, and if patients experience fewer disruptions to daily activities.

If Lu AG09222 works as a preventive drug, it would reduce patient reliance on acute migraine therapy.

Patients with Migraine respond to different drugs so there is a great need for other, new treatment. Some patients respond to one of the triptans, which are now generic and cheaper, but some respond to sumatriptan while others respond to rizatriptan. Some patients respond to Excedrin (over the counter treatment which is aspirin and caffeine) while others need expensive Nurtec or others need Qulipta to effectively treat their migraine.

Challenges of Lu AG09222

In the future biomarkers for Migraine treatment may be developed for clinical use. This could reveal what is already known clinically, that 70-80% of patients will respond to a triptan. Heart disease limits the use of triptans. The percentage of patients that will respond to Lu AG09222 is not now known.

Long term monitoring of Lu AG09222 may reveal other clinical or lab restrictions.

Despite these hurdles, the potential of Lu AG09222 to address a significant unmet need in migraine care cannot be overstated.

Conclusion

Lu AG09222 represents an exciting frontier in Migraine prevention, offering hope to millions of individuals. Targeting PACAP, this innovative therapy has the potential to change the landscape of migraine treatment, shifting the focus from reactive management to proactive prevention.

As research progresses, the promise of Lu AG09222 serves as a testament to the power of scientific innovation in addressing complex neurological disorders. For migraine sufferers, a brighter, pain-free future may be on the horizon.

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Britt Talley Daniel MD

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