MedPath

Calcitonin gene-related peptide

Generic Name
Calcitonin gene-related peptide
Drug Type
Biotech
CAS Number
83652-28-2
Unique Ingredient Identifier
JHB2QIZ69Z
Background

A 37-amino acid peptide derived from the calcitonin gene. It occurs as a result of alternative processing of mRNA from the calcitonin gene. The neuropeptide is widely distributed in the brain, gut, perivascular nerves, and other tissue. The peptide produces multiple biological effects and has both circulatory and neurotransmitter modes of action. In particular, it is a potent endogenous vasodilator.

As a potential drug, it has demonstrated in preclinical studies a profile that could make it an ideal anti-asthmatic drug candidate with bronchodilatory, bronchoprotecting and anti-inflammatory properties.

Indication

Investigated for use/treatment in myocardial infarction, heart disease, and asthma.

Ubrogepant Shows Promise in Treating Migraine Prodromal Symptoms in Phase III Trial

• A phase III clinical trial reveals that ubrogepant, an approved migraine medication, can effectively alleviate debilitating prodromal symptoms like fatigue, light sensitivity, and concentration difficulties that precede migraine headaches. • The PRODROME study demonstrated that patients taking ubrogepant during the prodromal phase experienced significant reductions in symptoms compared to placebo, with 46% preventing moderate to severe headaches versus 29% with placebo. • This breakthrough represents the first evidence that migraine can be interrupted in its earliest stages, suggesting central nervous system origins and potentially offering patients relief from disabling symptoms before headache onset.

Fremanezumab Shows Dual Efficacy in Treating Both Migraine and Depression in Landmark Trial

• A groundbreaking clinical trial demonstrates that fremanezumab, a CGRP-targeting monoclonal antibody, significantly reduces both migraine frequency and depressive symptoms in patients with comorbid conditions. • The UNITE study involving 540 patients across 12 countries showed fremanezumab reduced monthly migraine days by 5.1 compared to 2.9 with placebo, with 40% of treated patients achieving at least 50% reduction in migraine days. • This represents the first placebo-controlled trial to demonstrate significant improvements in both migraine and depression with a single pharmacological intervention, potentially reducing the cumulative burden on patients.

FDA Approves CT-132: First Digital Therapeutic for Episodic Migraine Prevention

• The FDA has approved Click Therapeutics' CT-132 as the first prescription digital therapeutic for preventive treatment of episodic migraine in adults, offering a smartphone-based intervention alongside traditional treatments. • Clinical trials demonstrated CT-132 significantly reduced monthly migraine days by approximately 3 days after 12 weeks, with a 0.9-day advantage over the control group (p=.005) and improvements in quality of life measures. • The app-based therapy works by modulating dysfunctional neurocircuitry associated with migraine through behavioral techniques including cognitive behavioral therapy elements, targeting sensory, autonomic, and affective networks.

Lundbeck's Vyepti Demonstrates Sustained Efficacy in Migraine Prevention at AAN 2025

• New data presented at AAN 2025 shows Lundbeck's Vyepti provides sustained efficacy for migraine prevention, with significant improvements in patient-reported outcomes including brain fog reduction. • The American Headache Society's 2024 statement recommends anti-CGRP monoclonal antibodies like Vyepti as first-line preventive treatments due to superior efficacy and tolerability compared to traditional oral options. • Despite competition from other anti-CGRP therapies, Lundbeck aims to differentiate Vyepti by highlighting meaningful patient benefits, though insurance implementation of new guidelines remains uncertain due to cost considerations.

FDA Accepts Teva's Application for AJOVY in Pediatric Migraine Prevention, Potentially First CGRP Antagonist for Children

• The FDA has accepted Teva Pharmaceuticals' supplemental Biologics License Application for AJOVY (fremanezumab) to expand its indication to include prevention of episodic migraine in children and adolescents aged 6-17 years weighing at least 45 kg. • The application is supported by positive Phase 3 SPACE trial results, which demonstrated statistically significant reductions in monthly migraine days and monthly headache days compared to placebo, with a safety profile consistent with adult populations. • If approved, AJOVY would become the first calcitonin gene-related peptide (CGRP) antagonist indicated for migraine prevention in both adults and pediatric patients, addressing a significant unmet need in pediatric migraine care.

Galcanezumab Shows Significant Promise in First Randomized Trial for Vestibular Migraine Treatment

• The INVESTMENT trial demonstrates galcanezumab's effectiveness in treating vestibular migraine, with patients showing significant reduction in definite dizzy days from 17.9 to 6.6 compared to placebo. • Treatment with galcanezumab led to substantial improvements in dizziness handicap scores, with patients experiencing a 22-point reduction compared to 8.3 points in the placebo group. • 71% of patients receiving galcanezumab reported moderate or greater treatment effects, marking a significant advancement in therapeutic options for vestibular migraine management.

United Therapeutics' UKidney Xenotransplant Trial Receives FDA Clearance

• United Therapeutics received FDA clearance for its IND application to begin clinical trials for UKidney, a gene-edited pig kidney, marking a significant step in xenotransplantation. • The phase 1/2/3 trial will enroll ESRD patients, including those ineligible for traditional transplants and those unlikely to receive a kidney within five years. • UKidney features 10 gene edits to enhance compatibility and reduce rejection, offering a potential alternative to dialysis for patients with limited options. • The trial's primary endpoints include patient and UKidney survival rates, changes in glomerular filtration rate, and quality of life improvements over a 24-week period.

FDA Approves Axsome's Symbravo (Meloxicam and Rizatriptan) for Acute Migraine Treatment

• The FDA has approved Symbravo (meloxicam and rizatriptan) for the acute treatment of migraine with or without aura in adults, offering a novel multi-mechanistic approach. • Clinical trials demonstrated that Symbravo can rapidly eliminate migraine pain and allow patients to return to normal functioning with a single dose. • Studies showed a statistically significant percentage of patients achieved pain freedom and were free from their most bothersome symptom within two hours of dosing versus placebo. • Axsome Therapeutics anticipates Symbravo will be commercially available in the U.S. in approximately four months, providing a new option for migraine sufferers.

Combined IPL and Botulinum Toxin Shows Promise in Treating Rosacea, Latin American Study Finds

A groundbreaking study demonstrates the effectiveness of combining Intense Pulsed Light (IPL) and Botulinum neurotoxin Type A (BoNT/A) in treating erythematotelangiectatic rosacea. The research, conducted on Latin American patients with Fitzpatrick skin type III, showed significant improvement in rosacea symptoms, with 12 out of 14 patients achieving mild or normal status post-treatment.

FDA Rejects Satsuma's STS101 Nasal Migraine Treatment Citing Manufacturing Issues

• The FDA issued a complete response letter for Satsuma Pharmaceuticals' STS101, a nasal powder formulation of dihydroergotamine mesylate (DHE), due to chemistry, manufacturing, and controls (CMC) issues. • STS101 aimed to offer a portable, easy-to-use option for acute migraine, potentially improving upon existing DHE nasal sprays like Bausch Health's Migranal. • The rejection positions Satsuma behind competitors like Impel Neuropharma (Trudhesa) and Pfizer (Zavzpret) in the crowded acute migraine treatment market. • Satsuma plans to meet with the FDA to determine the timeline for resubmitting the marketing application, emphasizing that clinical data was not a concern.

FDA Gears Up for Critical Decisions on Alzheimer's, Breast Cancer, and Neurological Therapies in Early 2025

• The FDA is set to decide on Biogen and Eisai's Leqembi for monthly intravenous maintenance in early Alzheimer's disease, potentially improving patient convenience. • AstraZeneca and Daiichi Sankyo await a decision on Dato-DXd for metastatic HR-positive, HER2-negative breast cancer, offering a new antibody-drug conjugate approach. • Vertex's suzetrigine, a non-opioid analgesic for moderate-to-severe acute pain, anticipates FDA verdict, representing a novel drug class for pain management. • SpringWorks' mirdametinib is under priority review for neurofibromatosis type 1-associated plexiform neurofibromas, addressing a significant unmet need.

Atogepant Shows Rapid Migraine Relief in Clinical Trials

• Atogepant, a CGRP receptor antagonist, demonstrates rapid reduction in migraine symptoms, potentially starting from the first dose. • Clinical trials (ADVANCE, ELEVATE, PROGRESS) show atogepant outperforms placebo in reducing migraine days within the first four weeks of treatment. • Patients on atogepant reported improvements in daily activities and overall quality of life compared to those on placebo. • The drug's quick onset may encourage treatment adherence, offering hope for those who have discontinued other migraine medications.

Alterity's ATH434 Shows Promise in Phase 2 Trial for Multiple System Atrophy

• Alterity Therapeutics' ATH434 demonstrated a statistically significant 48% slowing of clinical progression in early-stage MSA patients at the 50 mg dose. • MRI biomarkers indicated that ATH434 reduced iron accumulation in key brain regions affected by MSA, suggesting a potential disease-modifying effect. • The Phase 2 trial showed a favorable safety profile for ATH434, with most adverse events being mild to moderate and no treatment-related serious adverse events reported. • Alterity plans to engage with the FDA to discuss accelerating the development of ATH434, addressing the unmet need for MSA treatments.

Bexicaserin Shows Sustained Seizure Reduction in Developmental Epileptic Encephalopathies

• Bexicaserin demonstrated a 59.3% median reduction in countable motor seizures over 12 months in patients with developmental and epileptic encephalopathies (DEEs). • The PACIFIC open-label extension study showed consistent seizure reduction in both patients who switched from placebo to bexicaserin and those who continued treatment. • Longboard Pharmaceuticals, now acquired by Lundbeck, is advancing bexicaserin into Phase 3 trials, including the DEEp SEA study for Dravet syndrome. • Bexicaserin's favorable safety profile and tolerability were maintained throughout the 12-month extension, supporting its potential as a treatment for DEEs.

Vyepti (Eptinezumab) Demonstrates Efficacy in Phase III SUNRISE Trial for Migraine Prevention

• Lundbeck's Vyepti (eptinezumab) met the primary endpoint in the Phase III SUNRISE trial, significantly reducing monthly migraine days compared to placebo. • The SUNRISE trial confirmed Vyepti's efficacy in chronic migraine patients in Asia, with statistically significant reductions observed from day 1 post-infusion. • Vyepti demonstrated a favorable safety profile in the SUNRISE trial, consistent with previous studies, supporting its potential as a preventive migraine treatment. • Lundbeck plans to engage with regulatory authorities to potentially make Vyepti available for migraine sufferers across Asia based on the positive trial results.

FDA Accepts Satsuma and SNBL's NDA Resubmission for STS101 Migraine Treatment

• The FDA has accepted for review Satsuma Pharmaceuticals and SNBL's resubmitted NDA for STS101, a dihydroergotamine nasal powder, for acute migraine treatment. • The PDUFA date is set for April 30, 2025, offering hope for the nearly 40 million Americans suffering from migraine, especially women in their 20s to 40s. • STS101 is designed for quick self-administration, leveraging a proprietary nasal delivery device for rapid DHE absorption and sustained plasma concentrations. • The resubmission addresses FDA's previous concerns related to formulation, with no additional clinical trials requested, marking a significant step toward potential approval.

Click Therapeutics Highlights PDURS Potential to Revolutionize Digital Therapeutics

• Click Therapeutics emphasizes the potential of Prescription Drug Use Related Software (PDURS) guidance to revolutionize digital therapeutics by creating a combination pathway with traditional drugs. • The company's hybrid model, combining digital medicines with traditional pharma partnerships, distinguishes it from other digital therapeutic companies, focusing on data-driven outcomes and clinical rigor. • Click Therapeutics' migraine drug study showed positive results, utilizing traditional validated drug scales for comparison, and the company aims to expand its digital drug development across various therapeutic areas. • PDURS guidance could expedite market access through existing payer coverage, bypassing standalone digital reimbursement challenges, and potentially revitalize the digital therapeutics industry by demanding clinical rigor.

Rimegepant Shows Consistent Efficacy and Safety in Pooled Migraine Trial Analysis

• Pooled analysis of four randomized, placebo-controlled trials demonstrates rimegepant's statistically significant benefits in acute migraine treatment. • Rimegepant 75 mg showed superiority over placebo in achieving pain freedom and freedom from the most bothersome symptom at 2 hours post-dose. • The analysis supports early and consistent use of rimegepant, highlighting its flexibility for both acute and preventive migraine treatment. • Rimegepant's effectiveness leads to reduced use of rescue medications, potentially decreasing the risk of medication overuse headache and chronic migraine.

Tolebrutinib Shows Promise in Slowing Disability Progression in Non-Relapsing Secondary Progressive MS

• Tolebrutinib significantly delayed the onset of 6-month confirmed disability progression by 31% compared to placebo in patients with nrSPMS. • The proportion of patients experiencing confirmed disability improvement nearly doubled with tolebrutinib compared to placebo, indicating potential for functional gains. • Safety data showed liver enzyme elevations as a notable adverse event, but most cases resolved without intervention, emphasizing the need for careful monitoring. • HERCULES trial results support tolebrutinib as a potential treatment for nrSPMS, addressing a significant unmet need in managing disability accumulation.

Ubrelvy Shows Promise in Halting Migraines at Earliest Signs

• A clinical trial reveals that ubrogepant (Ubrelvy) may effectively stop migraines when taken at the first signs of an attack. • Participants taking ubrogepant were 73% more likely to report no disability and normal function compared to those on a placebo. • 65% of patients taking ubrogepant reported minimal migraine symptoms 24 hours later, versus 48% in the placebo group. • The drug targets CGRP, a protein instrumental in migraine processes, offering a proactive approach to migraine management.
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