The prevalence of gastrointestinal disorders caused by alcohol, Helicobacter pylori, non-steroidal anti-inflammatory drugs, chronic stress and sedentary lifestyle is on the rise. Calcitonin gene-related peptide (CGRP), a 37-amino acid neuropeptide, has emerged as a protective factor against various gastrointestinal issues. Despite its known benefits, the dual role of CGRP in gastrointestinal damage remains unclear. Discovered 30 years ago through alternative RNA processing of the calcitonin gene, CGRP is known to be a potent vasodilator involved in crucial defensive mechanisms for both physiological and pathological conditions. Promising evidences from preclinical research have attracted the interest of scientists for the exploration of CGRP as a therapeutic neuropeptide. Numerous evidences suggest that this neuropeptide is secreted by the neurons under the influence of endogenous as well as exogenous stimuli. CGRP repairs the gastric mucosal barrier and maintain mucosal integrity by suppressing NF-κB activation, thereby reducing tumour necrosis factor-alpha expression. In addition, recent studies suggest that CGRP modulates immune responses and enhances epithelial cell proliferation, further contributing to its cytoprotective effects. Consequently, CGRP and the CGRP secretagogues represent promising novel targets for clinical applications. This review aims to elucidate the role of CGRP and CGRP secretagogues in the management of gastrointestinal disorders, highlighting its potential as a therapeutic agent in the context of evidence-based modern gastroenterology.

2024-12-01·Expert Review of Neurotherapeutics

Intranasal zavegepant for the acute treatment of migraine

Review

作者: Monteith, Teshamae ; Greco, Guy

INTRODUCTIONMigraine is a highly prevalent chronic, inherited neurological condition of the brain which carries a significant level of disability. Despite advances, there is an unmet need for more effective therapies.AREAS COVEREDZavegepant nasal spray is a recent therapeutic option which acts as a calcitonin gene-related peptide receptor antagonist. The objective is to review the efficacy, safety, and additional results of the most recent trials investigating intranasal zavegepant for the acute treatment of migraine with or without aura. The authors searched PubMed using the keywords 'zavegepant,' 'Zavzpret,' 'migraine,' 'calcitonin gene-related peptide,' 'CGRP receptor antagonists.' This article covers Phase 1, Phase 2/3, and Phase 3 randomized, double-blind, placebo-controlled trials to evaluate the efficacy of intranasal zavegepant for treatment of acute migraine attacks.EXPERT OPINIONIntranasal zavegepant is an efficacious, safe, and tolerable anti-migraine drug based on clinical trials and clinical experience. It is especially useful for patients who experience attacks of sudden onset, those with nausea or vomiting, or a high cardiovascular risk burden. Dysgeusia was common; future studies are needed to better characterize this adverse event. Head-to-head studies are lacking with other migraine-specific therapies; the decision to treat should be patient-centered, with attack-specific characteristics in mind.

2024-08-02·Expert Review of Neurotherapeutics

An update on pharmacotherapy for trigeminal neuralgia

Review

作者: LeQuang, Jo Ann ; Pergolizzi, Joseph V. ; Varrassi, Giustino ; Wagner, Morgan ; El-Tallawy, Salah N. ; Ahmed, Rania S.

INTRODUCTIONTrigeminal neuralgia is a rare condition that can be effectively treated by carbamazepine or oxcarbazepine but these older drugs are associated with dose-dependent and potentially treatment-limiting adverse effects. Third-generation anticonvulsants, new calcitonin gene-related peptide blockers for migraine, and older drugs such as ketamine and cannabinoids may be promising adjuvants or monotherapeutic options.AREAS COVEREDThe new drugs, their presumed mechanisms of action, safety and efficacy are discussed herein. There is a paucity of robust clinical evidence in support of these drugs for trigeminal neuralgia. New migraine agents are considered as well although migraines and trigeminal neuralgia are distinct, albeit similar, conditions. No new drugs have been released to market in recent years with the specific indication of trigeminal neuralgia.EXPERT OPINIONIn real-world clinical practice, about half of trigeminal neuralgia patients take more than one agent for prevention and combination therapy may be the optimal approach. Combination therapy might allow for lower doses of carbamazepine or oxcarbazepine, thus reducing the number and severity of potential adverse events but the potential for pharmacokinetic drug-drug interactions must be considered. Drug therapy for trigeminal neuralgia involves acute or abortive treatments, often administered in hospital versus long-term preventive therapy, usually involving oral agents.

100 项与 Calcitonin gene-related peptide( Tokyo Medical University) 相关的药物交易

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