Migraine prophylaxis: investigational agents

Evidence-based neurology checklist on migraine prophylaxis: investigational agents: PACAP pathway PACAP is pituitary adenylate cyclase-activating polypeptide It is a vasoactive peptide It selectively activates the PAC1 receptor PACAP plays a role in migraine pathophysiology independent from CGRP…

PACAP pathway

  • PACAP is pituitary adenylate cyclase-activating polypeptide
  • It is a vasoactive peptide
  • It selectively activates the PAC1 receptor
  • PACAP plays a role in migraine pathophysiology independent from CGRP

PACAP pathway modulators

Other pathways

References

  1. Ashina M, Phul R, Khodaie M, Löf E, Florea I. A monoclonal antibody to PACAP for migraine prevention. N Engl J Med 2024; 391:800-809.
  2. Ashina H, Christensen RH, Hay DL, et al. Pituitary adenylate cyclase-activating polypeptide signalling as a therapeutic target in migraine. Nat Rev Neurol 2024; 20:660-670.
  3. Schytz HW, Olesen J, Ashina M. The PACAP receptor: a novel target for migraine treatment. Neurotherapeutics 2010; 7:191-196.
  4. Kuburas A, Russo AF. Shared and independent roles of CGRP and PACAP in migraine pathophysiology. J Headache Pain 2023; 24:34.
  5. Guo S, Jansen-Olesen I, Olesen J, Christensen SL. Role of PACAP in migraine: an alternative to CGRP? Neurobiol Dis 2023; 176:105946.
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