TEACHABLE MEDICAL NEWS

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Tag: pain

Can an injectable treatment reduce cluster headaches?

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On November 30, 2019

In cellular basis of life, lymphatic and immune system, nervous system

TeachableMedicalNews article 11302019

Teachable moment in classrooms:

  1. Cellular basis of life chapter – receptors on cell membranes bind ligands
  2. general senses chapter – unconventional types of pain
  3. general senses chapter – pharmaceuticals of pain control
  4. immune system chapter – antibodies as pharmaceuticals

The news item:  A new injectable treatment for cluster headaches has recently been in the news:

Emgality Receives First FDA Approval for Treating Cluster Headache

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The article mentions the similarity of the pain of cluster headaches to that of migraines, and the approval of the drug Emgality (galcanazumab).

So, Why Do I Care??

About 1 million people suffer from a debilitating disorder, cluster headaches, in the USA.  While there are several therapeutic approaches to cluster headaches, but their effectiveness varies, and many of those treatments have unpleasant side effects.

Plain English, Please!!!  First, let’s talk about cluster headache.  Cluster headache a quick onset and intensely painful type of headache.  That pain makes patients disfunctional, and many cases the pain wakes them up at night, and, so, that is why this disorder is so debilitating.  The headaches happen during a particular time of the day, because these headaches are linked to the body’s own internal clock.

Second, let’s talk about pain, this warning signal of our nervous system.  We sense pain when tissue damage triggers nerve impulses in the nerve cells of the damaged body area, and those neurons conduct the nerve impulse to the brain

Third, let’s talk about this new treatment for cluster headache.  Because cluster headache is not the result of tissue damage, common pain killers don’t work well on cluster headache pain.  Many years of research identified a chemical that trigger cluster headache pain; that chemical is called calcitonin gene related peptide (CGRP).  Cluster headaches happen when CGRP reaches receptors on neurons in the brain.   So, how can you block the action of that peptide?  Imagine a football game where the defensive tackle wraps his arms around the running back to keep him out of the end zone.  The drug mentioned in the article, galcanezumab, acts like a defensive tackle wrapping arms around the running back CGRP, and keeping it away from receptors on neurons in the brain.  The defensive tackle, galcanezumab, can target CGRP only, because galcanezumab is a modified antibody, a protein made by immune system cells to specifically target invaders in the body. As antibodies are proteins, they can not be taken orally, but have to be injected.

Can an injectable treatment work for migraines?

By

On July 31, 2019

In lymphatic and immune system, nervous system

TeachableMedicalNews article 07312019

Teachable moment in classrooms:

  1. general senses chapter – unconventional types of pain
  2. general senses chapter – pharmaceuticals in of pain control
  3. immune system chapter – antibodies as pharmaceuticals

 

Can an injectable treatment work for migraines?

 The news item:  New injectable preventions and treatments for migraine were in the news recently. One of them is Aimovig (erenumab):

FDA approves new drug that stops chronic migraines

The FDA approves, Erenumab, a new migraine treatment, that blocks chronic and disabling headaches, without causing many side effects.

The article mentions migraine statistics, the calcitonin gene related peptide (CGRP) as the culprit in migraines, and that the new drug is an antibody.

 

So, Why Do I Care??  There are about 39 million migraine sufferers in the USA.  Among them about 4 million who suffers from chronic migraine lasting for 10-14 days.  The impact of migraine is more than the personal suffering; the US economy loses $36 billion yearly because of lost productivity linked to migraine.  While occasional migraine can be successfully treated with common medications, the chronic migraine sufferers don’t have a reliable treatment.

 

Plain English, Please!!!  First, let’s talk about migraine.  Migraine is a disorder of the central nervous system, and during a migraine attack the malfunctioning nervous system creates pain in the head area, visual disturbances (auras), and sometimes dizziness and nausea.   So, that’s why this disorder is so debilitating.

Second, let’s talk about pain, this warning signal of our nervous system.  We sense pain when tissue damage triggers nerve impulses in the nerve cells of the damaged body area, and those neurons conduct the nerve impulse to the brain.  Everyday pain killer drugs either block the action of chemical released during tissue damage, or they block the movement of the nerve impulse to the brain.

Third, let’s talk about this new treatment for migraine. Because migraine is not the result of tissue damage, common pain killers don’t work on chronic migraine pain.  Many years of research identified a chemical that trigger migraine pain; that chemical is called calcitonin gene related peptide (CGRP).  Migraine happens when CGRP reaches receptors on the neurons in the brain.   The receptor is like a wide receiver in football; the peptide has to be caught by the receptor to start migraine pain, like the wide receiver has to catch the football for a touchdown.  So, how can you block the action of that migraine-triggering peptide?  Imagine a football game where the arms of the wide receiver are duct taped to his body.  The drug erenumab does that to the receptor, so the CGRP peptide can not be caught by the receptor, so there is no more triggering of pain.  The duct tape, erenumab, can target CGRP receptors only, because erenumab is a modified antibody, a protein made by immune system cells to specifically target invaders in the body. As antibodies are proteins, they can not be taken orally, but have to be injected.

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