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Galcanezumab modulates Capsaicin-induced C-fiber reactivity

Galcanezumab modulates Capsaicin-induced C-fiber reactivity

Authors :
Hauke Basedau
Thalea Oppermann
Elisa Gundelwein Silva
Kuan-Po Peng
Arne May
Source :
Cephalalgia. 42:1331-1338
Publication Year :
2022
Publisher :
SAGE Publications, 2022.

Abstract

Background The vasodilatory calcitonin-gene related peptide (CGRP) is understood as pivotal mediator in migraine pathophysiology. Blocking CGRP with small molecules or monoclonal antibodies (CGRP-mAb) reduces migraine frequency. However, prescription of CGRP-mAbs is still regulated and possible predictive measures of therapeutic success would be useful. Methods Using standardized capsaicin-induced dermal blood flow model, 29 migraine patients underwent a laser speckle imaging measurement before and after administration of galcanezumab. At both sessions dermal blood flow before and after capsaicin stimulation as well as flare size were analyzed over all three trigeminal branches and the volar forearm for extracranial control. Long-term measures were repeated in 14 patients after continuous treatment ranging from 6 to 12 months. Results Resting dermal blood flow remained unchanged after administration of galcanezumab. Capsaicin-induced dermal blood flow decreased significantly after CGRP-mAb in all tested areas compared to baseline and this was consistent even after 12 months of treatment. However, following galcanezumab administration, the flare size decreased only in the three trigeminal dermatomes, not the arm and was therefore specific for the trigemino-vascular system. None of these two markers distinguished between responders and non-responders. Conclusion CGRP-mAb changed blood flow response to capsaicin stimulation profoundly and this effect did not change over a 12-month application. Neither capsaicin-induced flare nor dermal blood flow can be used as a predictor for treatment efficacy. These data suggest that the mechanism of headache development in migraine is not entirely CGRP-mediated.

Details

ISSN :
14682982 and 03331024
Volume :
42
Database :
OpenAIRE
Journal :
Cephalalgia
Accession number :
edsair.doi.dedup.....3104489014fd6085b39a810b19e2cf26
Full Text :
https://doi.org/10.1177/03331024221112906