Santander, June 10 (EFE).- Headaches, a practically “universal” problem, have a “big culprit”, the CGRP molecule, which could be the biomarker that neurology needs to confirm diagnoses, follow up on patients and to know the effectiveness of the treatments.
In an interview with EFE, neurologists from the Cantabrian hospital in Valdecilla, Julio Pascual and Vicente González-Quintanilla, review the advances in headache research, the central theme of a congress that they are organizing these days in Santander to encourage young doctors to take an interest in the headache because “it is so frequent that they should know how to handle it” even if they are not specialists.
Migraine regularly affects more than five million Spaniards, especially women between the ages of 20 and 40, who are the most common face of the disease.
However, headache treatments have experienced “a tremendous boost” thanks to better knowledge of the mechanisms that generate it.
Specifically, Pascual points out, the calcitonin gene-related peptide (CGRP) has shown the “greatest role” in the pathophysiology of migraine. “It triggers the mechanisms that end up producing pain,” he explains.
For example, patients with chronic migraine, which is suffered by those who suffer from this condition more than half the days of the year, have higher levels of this peptide, the biomarker that neurology looks for.
Julio Pascual compares it with another meter such as blood glucose, which indicates the concentration of glucose in the blood and makes it possible to detect diabetes. “It is what we have to investigate, we are getting closer,” he says.
The diagnosis of headaches is still clinical and, as in many other neurological diseases, “something to confirm it” is needed.
“For a few years we have known about the big culprit (CGRP), which has made it possible to develop drugs for the first time that are specific for the treatment of migraine,” says Revuelta about these drugs, which “have the great advantage that they are very well tolerated, very effective” and can also reduce the number of days of pain in chronic patients.
For the symptomatic treatment of migraine, “a new generation of anti-CGRP drugs” is arriving, called gepants, and for a preventive approach there are monoclonal antibodies, which are artificial proteins that act as antibodies.
WAY TO GO
Despite the fact that “much” progress has been made, neurologists assure that “there is a long way” to go. “We know, for example, that there is some other molecule involved (in headache) that is being studied,” they point out because, in addition, “one hundred percent of patients do not respond to these anti-CGRP drugs.”
“The first results of clinical trials are promising, probably those patients who do not respond to anti-CGRP may respond to these other drugs that go against the other peptides,” they point out.
Another objective, to which these neurologists try to respond with the second Meeting of Northern Headaches, in which clinicians and researchers from Asturias, Castilla y León, Navarra and the Basque Country participate, is that any doctor is capable of successfully addressing the first attention to headache, without the need to be a specialist.
When the pain begins to interfere with a certain frequency, “it is very convenient to consult the doctor,” recommends Julio Pascual, who also does not censure those who take an analgesic or an anti-inflammatory at home “and do well.” “There is no need to demonize it,” he adds.
Pablo G. Hermida
