Pituitary adenyl cyclase-activating polypeptide (PACAP) are neuropeptides.
After CGRP antagonists and monoclonal antibodies targeting CGRP receptors, PACAP are newer targets for migraine headache.
In a recent study, intravenous infusion of drugs targeting PACAP receptors improved migraine headache in refractory cases in half of the patients.
For migraine prevention, there are two main targets. The first is calcitonin gene-related peptide (CGRP), for which we have monoclonal antibodies as a treatment option.
Recently, a new target has emerged—pituitary adenyl cyclase-activating polypeptide (PACAP). Administering PACAP intravenously can trigger migraines in patients who suffer from them.
A new approach for migraine prevention involves developing a monoclonal antibody that targets PACAP.
In a study published in The New England Journal of Medicine, a research team from Denmark conducted a phase 2 trial with 237 patients who had not responded to at least two previous preventive therapies.
The participants received a single dose of a monoclonal antibody, and compared to the placebo group, the antibody significantly reduced the number of migraine days over the following 4 weeks.
However, while there was a notable trend in the 50% responder rate, it was not statistically significant. The treatment was generally well tolerated.