Definition
Calcitonin Gene-Related Peptide
Calcitonin gene-related peptide (CGRP) is a neuropeptide released from trigeminal nerve terminals that drives neurogenic inflammation and meningeal vasodilation in migraine attacks.
Therapeutic Targeting
Pharmacological modulation
- Receptor antagonists: Gepants such as rimegepant block the CGRP receptor for acute treatment.
- Monoclonal antibodies: Erenumab, fremanezumab, galcanezumab, and eptinezumab target either the CGRP ligand or its receptor for prevention.
Clinical Context
Triptans reduce CGRP release via 5-HT1D receptor agonism. When this pathway fails, direct CGRP inhibition becomes the principal therapeutic strategy.