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  • Title: Calcitonin gene related peptide monoclonal antibody treats headache in patients with active idiopathic intracranial hypertension.
    Author: Yiangou A, Mitchell JL, Vijay V, Grech O, Bilton E, Lavery GG, Fisher C, Edwards J, Mollan SP, Sinclair AJ.
    Journal: J Headache Pain; 2020 Sep 25; 21(1):116. PubMed ID: 32988380.
    Abstract:
    BACKGROUND: Headache is the dominant factor for quality of life related disability in idiopathic intracranial hypertension (IIH) and typically has migraine-like characteristics. There are currently no evidence-based therapeutics for headache in IIH, and consequently this is an important unmet clinical need. CASE SERIES: We report a series of seven patients in whom headaches were the presenting feature of IIH and the headaches had migraine-like characteristics, as is typical in many IIH patients. Papilloedema settled (ocular remission) but headaches continued. These headaches responded markedly to erenumab, a monoclonal antibody targeted against the calcitonin gene related peptide (CGRP) receptor. Of note, there was a recurrence of raised ICP, as evidenced by a return of the papilloedema, however the headaches did not recur whilst treated with erenumab. CONCLUSIONS: Those with prior IIH who have their headaches successfully treated with CGRP therapy, should remain under close ocular surveillance (particularly when weight gain is evident) as papilloedema can re-occur in the absence of headache. These cases may suggest that CGRP could be a mechanistic driver for headache in patients with active IIH.
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