It’s very hard to be a person with migraine and not to have heard about the brand new class of drugs coming to the market called CGRP drugs. I don’t know about you guys but I have received at least 10 news articles talking about these drugs from family and friends asking me if I had tried this yet. My reply: I’ve waiting to try them for what feels like years! And I finally have, but more on that later. There are now three that have been approved by the FDA called AIMOVIG, AJOOVY, and Emagality. I thought it might be useful explain in brief what it is and what is the main difference between AIMOVIG and AJOOVY. Much of my research comes from a Facebook live by Dr. David Dodick, who is a Professor of Neurology at the Mayo Clinic in Phoenix and chair of the American Migraine Foundation hosted the foundation.
CGRP stands for Calcitonin Gene Related Peptide. CGRP has been known as a peptide in the body for more than 30 years. So it’s not actually a new thing. CGRP was speculated to be important in migraine back then, but because migraines were thought to be vascular in nature and CGRP is a potent vasodilator it was put on the back burner. CGRP has now been found to be important, because it transmits pain signals along the trigeminal nerve and into the brain. CGRP is a sensory signaling peptide that generates and maintains a migraine headache. Is this the magic bullet? Unfortunately, no, the jury is still out. They need thousands more people to try it to really see its full efficacy.
These drugs are not actually drugs at all. Dr. Dodick calls them biologics. They are synthetic peptides engineered to specifically target a protein or its receptor. The good news means that they are not metabolized by the liver, because phew my poor liver needs a break. They do not cross the blood brain barrier. More good news, nothing extra messing with your highly sensitive migraine brain. Finally, these peptides aren’t processed by your kidneys either! What does all this mean! A VERY LOW side effect profile. How many other migraine preventatives can say that? I know for years I’ve been going to my neurologist’s office and whenever she suggests a new drug my first question is what are the side effects? Why because often in my experience the side effects can be worse than the migraine! No memory, psychosis, heart problems, those are just a few of mine!
One caveat is they are not sure what the long-term effects are of this drug and if you are at high risk for heart disease or stroke you might want to think twice, but as always discuss with your doctor. To me it just motivates me to keep the rest of my body as healthy as I can to be able to fight these migraines on the very best playing field I can create.
How do they work? Well it depends. AIMOVIG is an anti-CGRP receptor blocker. So it actually targets the CGRP receptor and prevents it from attaching. AJOOVY is an anti-CGRP peptide that actually breaks up the CGRP being produced by our bodies. To use Dr. Dodicks analogy is that AIMOVIG is like gumming up a lock so the key won’t fit in, and AJOOVY is as if you take the key and snap it before it can unlock the door to pain. Both seem to be equally effective in trials so how do you chose which one to try? Unfortunately, this is where the trial and error thing comes in again just like all the other migraine preventatives we’ve tried. You just have to pick one and see if it works. And if it doesn’t you pick the next one.
As I mentioned earlier, I injected my self with AIMOVIG about 15 days ago. Why did I choose AIMOVIG? It was out first, I’m afraid I’m not a patient person, so that’s the way things go for me. Besides it’s hard to be patient while living in so much pain. How is it working? So far so good. I have had ZERO migraines since injecting myself, as compared to last month when I had a relatively low 4 migraines. I am currently going through my cycle which is the worst time of the month for me. And I must say I have had twinges of pain but nothing has developed into migraine and I haven’t taken any other abortive drugs. I am still taking my other preventative medications. I am cautiously optimistic because I have been here before, but since they effects are said to be cumulative I can’t wait to see what happens next month! Are you planning to try a new CGRP drug? Which one? Please comment below.