Although headache treatment is not always effective, patients and doctors have hope of developing new drugs, since chronic headache is at the epicenter of the latest research and development of the pharmaceutical industry.
At various stages of development and clinical trials, there is a wide range of drugs acting on specific receptors and used in the emergency treatment of headaches. Some new drugs with specific mechanisms of action are described below.
Another important target for therapeutic treatment may be the CRG receptors. The promising results of the intravenous use of an HGHR antagonist (BIBN4096BS) and oral MK-0974 have been published. Intravenous administration of 2.5 mg of BIBN4096BS reduced headache within 2 hours in 66% of cases compared with the placebo group (27%).
Analysis of the results of phase III of the clinical study showed that the new oral antagonist of the CRP receptor (MK-0974) and rizatriptan® have comparable efficacy.
Relief of pain for 2 hours was noted in 68% of subjects who took 300 mg of MK-0974, compared with 70% of those who took 10 mg of Rizatriptan®.
CRP receptor antagonists do not have a direct vasoconstrictor action, so they can be a good alternative for patients who are contraindicated triptans due to the risk of developing cardiovascular diseases or triptans inefficiency.
In treating headaches, carbon dioxide is of particular interest. Experimental studies have shown the ability of CO2 to suppress the activation of sensitive terminals and the release of OGCs, as proposed mechanisms to relieve headaches. The results of Phase II of the clinical study showed the effectiveness of 100% C02, used intranasally with a speed of 10 ml / s.
TRPV1 vanilloid receptors, located in the nucleus of the trigeminal nerve and the posterior roots, can be additional centers of pain sensitivity and the point of application of therapeutic agents for the treatment of migraine headaches. A preliminary clinical study of the TRPV1 receptor antagonist (SB705498) was interrupted due to its low efficacy.
However, a variety of medicinal substances have been developed that have shown higher efficacy in the treatment of migraine. So, at present, clinical trials are undergoing MK-2295 for the treatment of toothache.
Nitric oxide is another important substance involved in the pathogenesis of migraine. Nitric oxide synthetase inhibitor (GW274150) has anti-inflammatory and analgesic effects. The results of Phase II clinical trials of GW274150 for the treatment of migraine attacks have been received but not yet published.
Improve the effectiveness of the treatment of migraine attacks will help new ways of drug administration. The results of Phase I clinical trials showed the advantages of using sumatriptan in the form of an ionophoretic skin patch, since this method of administering the drug reduces the number of undesirable drug reactions compared with its subcutaneous administration. Subsequently, clinical studies should evaluate the effectiveness of the ionophoretic patch.