Pain in Parkinson disease: mechanistic substrates, main classification systems, and how to make sense out of them - Archive ouverte HAL
Article Dans Une Revue La Revue du Praticien Médecine Générale Année : 2023

Pain in Parkinson disease: mechanistic substrates, main classification systems, and how to make sense out of them

[Anti-calcitonin generelated peptide (CGRP) therapies for migraine].

Résumé

ANTI-CALCITONIN GENE-RELATED PEPTIDE (CGRP) THERAPIES FOR MIGRAINE. Currently, four monoclonal antibodies targeting the CGRP (calcitonin gene-related peptide) pathway have been shown to be effective as migraine prophylactics: eptinezumab, erenumab, fremanezumab and galcanezumab. Unlike the usual preventive treatments, they are administered parenterally: subcutaneously (monthly or quarterly) or by quarterly IV infusion for eptinezumab. They reduce the frequency of attacks by at least 50% in 50 to 60% of migraine patients, even in cases of failure of several conventional preventive treatments, in cases of chronic migraine and medication overuse. Their tolerance is better than that of conventional oral treatments and the discontinuation rates are very low. They can be proposed after failure of at least two conventional prophylactic treatments, in patients with at least 8 migraine days per month and without cardiovascular pathology. Indeed, these drugs present a risk in case of cardiovascular disease, by inhibiting vasodilation, and are therefore contraindicated in this population. The main limitation to the use of these treatments in France at present is the lack of reimbursement, the cheapest molecule being available at a price of 245 € per injection.
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Dates et versions

hal-04721433 , version 1 (04-10-2024)

Identifiants

Citer

Xavier Moisset, Geneviève Demarquay. Pain in Parkinson disease: mechanistic substrates, main classification systems, and how to make sense out of them. La Revue du Praticien Médecine Générale, 2023, 73 (2), pp.123-126. ⟨10.1097/j.pain.0000000000002968⟩. ⟨hal-04721433⟩
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