Migraine: advances in treatment

Abstract Increased understanding of the pathophysiology of migraine has resulted in the development of therapies targeting calcitonin gene-related peptide and its receptor. Ditans, which are serotonin 5HT1F receptor agonists, have demonstrated efficacy in acute management and bypass vascular risks associated with triptans, which are 5HT1B/1D receptor agonists. However, despite favourable safety and efficacy data, many patients do not respond to these therapies. Treatments targeting pituitary adenylate cyclase activating polypeptide and other potential targets, including amylin and adrenomedullin and their receptors, KATP and transient receptor potential ion channels, as well as neuronal nitric oxide synthase, are emerging. Improving our understanding of patient heterogeneity in migraine biology may pave the way for precision medicine in migraine management.