People who get migraines know all too well that the condition is far more debilitating than “just a headache.” A migraine causes pain, sure, but it also brings on nausea, vomiting, sensitivity to noise and light. During an episode of migraine with aura, your vision may go blurry or wavy — or simply vanish. You may see, hear or feel things that aren’t there. You may find yourself slurring your speech, your tongue suddenly a foreign object in your mouth, or become overwhelmingly dizzy, weak or faint.
“Patients literally can’t function,” says Jennifer Kriegler, M.D., director of the Headache Medicine Fellowship at the Cleveland Clinic and associate professor of neurology at Case Western Reserve University. “Migraine affects people’s ability to work, to parent their children.”
Yet despite the severity of what is recognized as a neurological condition, treatment options for migraines have thus far been limited to drugs that can abort an oncoming headache or make it less severe.
Until now. Recently, the Food and Drug Administration approved a new type of drug that promises real relief from migraines by way of prevention. The drug, Aimovig (generic name Erenumab), is “extremely different than what’s been available,” says Kriegler. It works by targeting something called “calcitonin gene–related peptide,” or CGRP, a molecule that has been proven to play a key role in the development of migraines.
Clinical trials show the drug has the possibility to change lives. Though it doesn’t promise to prevent every migraine attack, Aimovig can make them much less intense and much less frequent — cutting the number of days that patients spend curled up in the fetal position by 50 percent or more. And unlike other migraine treatments, which often cause side effects like drowsiness, nausea or foggy thinking, the reported side effects for Aimovig are minimal.
Perhaps the most incredible thing about Aimovig, though, is the fact that it is the first and only drug that has been developed specifically to treat migraines — a condition that affects one in eight Americans and whose first written mention dates back to ancient Egypt.
“Every other medication in use today was approved and developed to treat another problem — high blood pressure, epilepsy, depression,” says Kriegler. Treating migraines was simply an unintended bonus that drugmakers stumbled upon after the fact. Which raises the question: What on earth has taken so long?
For one thing, scientists long lacked a clear understanding of the physiology of a migraine — what was actually happening in the body during an episode. Even after researchers made the connection between migraines and high blood levels of CGRP, developing a targeted therapy that worked proved difficult.
Still, many experts — including Kriegler — also attribute the pharmaceutical foot-dragging to the fact that the condition predominantly affects women, who are three times as likely as men to get migraines. “Just in terms of attitudes towards headache, this was not thought of as a big deal, even into the 1970s and ’80s. The sentiment was, ‘Oh, it’s a woman thing.’ Nobody really took it very seriously,” she says.
The good news is now that Aimovig has been approved, we may see more treatment options follow. According to Kriegler, there are at least three drugs in the pipeline that likely will be released in coming years, including better so-called abortive drugs that can stop a migraine after it starts.
In the meantime, if you think you could benefit from taking Aimovig, talk to your doctor. The medication, which is delivered in the form of a monthly self-injection, isn’t cheap. (It’ll cost $6,900 a year for those paying out of pocket — although Amgen, the manufacturer, says that those who qualify for assistance programs could get it for as little as $5 a month.) But in terms of quality of life, “what it offers is pretty astounding,” says Kriegler.
Manuela Bertoli
