Medications that block the action of calcitonin gene-related peptide (CGRP) are the new force in migraine treatment. Research spearheaded by Professor Peter Goadsby at King’s College, London, established that migraine was caused by “dysfunctional neuropeptide production in the trigeminal nerve”¹, which blew away previous notions of migraine being a vascular disorder, or allergic, or psychosomatic. That dysfunctional neuropeptide was CGRP, acting around the largest cranial nerve (the trigeminal nerve) in the body, which is responsible for processing sensory information and providing motor control of the face, including the forehead, cheeks, jaw and teeth. The new medications targeting CGRP have been developed specifically to treat migraine and include monoclonal antibodies and gepants.
At the time of the Migraine in Aotearoa New Zealand Survey 2022, which ran from 22 August to 7 October, there were two CGRP monoclonal antibodies available in the country, although neither were funded. These were erenumab (Aimovig) and galcanezumab (Emgality). Emgality had only been launched in September 2022 and Aimovig was only available from one pharmacy in Auckland and cost $678 a month (plus courier fees, if you weren’t in Auckland), so neither were widely accessible.
So it's not surprising to find that only 17 people were taking a CGRP monoclonal antibody at the time of the survey (4% of all respondents to the questions about these medications). What is surprising is that over half of respondents, and 76% of all those with chronic migraine, wanted to try a CGRP monoclonal antibody.