6 ms·
Anecdata: a close friend has suffered from terrible migraines for years. Triptans such as Sumatriptan/zolmatriptan helped, if taken with anti-sickness meds, but
by codeulike 5y ago
Anecdata: a close friend has suffered from terrible migraines for years. Triptans such as Sumatriptan/zolmatriptan helped, if taken with anti-sickness meds, but they were needing to take them too often and getting dependency headaches from them.
Over the years they tried many things which didn't really help, or seemed to help but then didn't, or were inconclusivbe.
About a year ago they started on Ajovy (fremanezumab), a CGRP inhibitor. Its been like magic. A simple injection every month (you can do it yourself - they courier them over and you keep them in the fridge) and barely any migraines. Sometimes one or two towards the end of the month when the next jab is due. And no real side effects as far as can be told.
Its unusual to come accross a medicine that works so well for something as intractable as migraines.
UK specific: Originally they were paying for the Ajovy after getting prescribed it by the brilliant National Migraine Center (https://www.nationalmigrainecentre.org.uk/ https://www.nationalmigrainecentre.org.uk/) - its expensive. But after it was shown to work managed to get it on the NHS via a referral to a specialist.
- the_d3f4ult 5y agoThese types of discoveries are becoming more and more common with the explosion of novel biologics.
- amatic 5y agoWhat are novel biologics?
- datameta 5y agoMedication that is past what is considered "large molecule" and in the size and complexity ballpark of proteins. These need to be injected as opposed to taken orally as they're too large to enter the bloodstream otherwise. There is a whole search space out there for medication of this class and we're only just getting started. It's (loosely) like finding out what is possible with a 100MB program vs a 50KB one.
- dm3 5y agoThis is very interesting. Are there any books you'd recommend on the topic which would explain the directions pharmaceutical science is heading towards to a layman?
- datameta 5y agoI'm not currently aware of a book on the subject, but would also like to read a compilation of the cutting edge. I am relaying what I know from tangentially following advances my peers participate in filtered through my former chemistry+bioinformatics background. Here is some more info on considerations to be had for near-future breakthroughs in the oral administration route. The key is in preserving the biologic structure long enough for it to reach the intestine where, in contrast to the stomach, it would be able to enter the bloodstream with the aid of agents that enhance permeability. https://otd.harvard.edu/explore-innovation/technologies/oral-delivery-of-biologics https://otd.harvard.edu/explore-innovation/technologies/oral... Edit: The field of cheminformatics is currently utilizing machine learning to help discover novel drugs in the various search spaces, such as that of kinase inhibitors. They have the ability to function in a multi-target regime. That is, there exist drugs that can be effective for several pathologies.
- GordonS 5y agoThis almost mirrors my own experience, only difference is I take erenumab instead of fremanezumab - it really has been a godsend!
- ortusdux 5y agoA friend's insurance would not continue to cover their preferred 'as needed' migraine medication until they tried Ajovy. Both doctor and patient were unhappy with the requirement, but damn if that shot didn't remove the existence of migraines from their life completely.
- Apofis 5y agoVery interesting case of an insurance company also being a healthcare provider.
- dmd 5y agoYep! I've been keeping a migraine diary since 1998. For twenty years I averaged 12-15 migraines a month, where I define a "recordable" migraine as one that stops me from doing anything other than taking care of the migraine for more than an hour. In 2018 I started Aimovig (later switching to Emgality). I now average between 0 and 1 migraine a month.