Treating headache comprising administering an antibody to calcitonin gene-related peptide
The invention features methods for preventing or treating CGRP associated disorders such as vasomotor symptoms and/or headaches (e.g., migraine, cluster headache, and tension headache) by administering an anti-CGRP antagonist antibody. Compositions for use in the disclosed methods are also provided. Antagonist antibody G1 and antibodies derived from G1 directed to CGRP are also described.
1. A method of treating or reducing incidence of headache associated with the administration of a substance or its withdrawal in a subject, comprising administering to the subject a monthly dose of a monoclonal antibody that inhibits the calcitonin gene-related peptide (CGRP) pathway, wherein the amount administered monthly is between 100-900 mg, wherein the monoclonal antibody comprises a CDR H1 as set forth in SEQ ID NO:3; a CDR H2 as set forth in SEQ ID NO:4; a CDR H3 as set forth in SEQ ID NO:5; a CDR L1 as set forth in SEQ ID NO:6; a CDR L2 as set forth in SEQ ID NO:7; and a CDR L3 as set forth in SEQ ID NO:8, and wherein the substance is an anti-headache medication.
2. The method of claim 1 , wherein the substance comprises ergot alkaloids, triptans, opioids, paracetamol, non-steroidal anti-inflammatory drugs, or a combination thereof.
3. The method of claim 2 , wherein the substance comprises an ergot alkaloid selected from ergotamine, dihydroergotamine, methysergide, ergotamine tartrate, ergonovine maleate, or ergoloid mesylates.
4. The method of claim 2 , wherein the substance comprises a triptan selected from sumatriptan, zolmitriptan, naratriptan, rizatriptan, eletriptan, almotriptan, or frovatriptan.
5. The method of claim 2 , wherein the substance comprises an opioid selected from morphine, heroin, hydromorphone, oxymorphone, levorphanol, levallorphan, methadone, meperidine, fentanyl, cocaine, codeine, dihydrocodeine, oxycodone, hydrocodone, propoxyphene, nalmefene, nalorphine, naloxone, naltrexone, buprenorphine, butorphanol, nalbuphine, or pentazocine.
6. The method of claim 2 , wherein the substance comprises a non-steroidal anti-inflammatory drug selected from aspirin, diclofenac, diflunisal, etodolac, fenbufen, fenoprofen, flufenisal, flurbiprofen, ibuprofen, indomethacin, ketoprofen, ketorolac, meclofenamic acid, mefenamic acid, nabumetone, naproxen, oxaprozin, phenylbutazone, piroxicam, sulindac, tolmetin, zomepirac, cyclooxygenase-2 (COX-2) inhibitors, celecoxib, rofecoxib, meloxicam, JTE-522, L-745,337, NS398, or a pharmaceutically acceptable salt thereof.
7. The method of claim 1 , wherein the subject experiences 15 or more monthly headache days before said administering.
8. The method of claim 1 , wherein the incidence of headache is reduced for at least seven days after a single administration.
9. The method of claim 1 , wherein monthly headache hours experienced by the subject after said administering is reduced by 40 or more hours from a pre-administration level in the subject.
10. The method of claim 1 , wherein monthly headache days experienced by the subject after said administering is reduced by 3 or more days from a pre-administration level in the subject.
11. The method of claim 1 , wherein monthly headache hours experienced by the subject after said administering is reduced by 25% or more relative to a pre-administration level in the subject.
12. The method of claim 1 , wherein the amount of the monoclonal antibody administered in a first month is different than the amount of the monoclonal antibody administered in a second month.
13. The method of claim 12 , wherein the amount of the monoclonal antibody administered in the first month is higher than the amount of the monoclonal antibody administered in the second month.
14. The method of claim 1 , wherein the administering is subcutaneous or intravenous administration.
15. The method of claim 1 , wherein the administering comprises utilizing a pre-filled syringe comprising the amount of the monoclonal antibody.
16. The method of claim 1 , wherein the monoclonal antibody is formulated at a concentration of at least 150 mg/mL.
17. The method of claim 1 , wherein the monoclonal antibody is administered in a volume of less than 2 mL.
18. The method of claim 1 , wherein the monoclonal antibody is administered in a volume of about 1.5 mL.
19. The method of claim 1 , wherein the amount of the monoclonal antibody administered monthly is about 225 mg.
20. The method of claim 1 , wherein the amount of the monoclonal antibody administered monthly is about 675 mg.
21. The method of claim 20 , wherein the amount of about 675 mg is administered as three injections of about 225 mg each.
22. The method of claim 19 , wherein the monoclonal antibody is formulated at a concentration of at least 150 mg/mL.
23. The method of claim 19 , wherein the monoclonal antibody is administered in a volume of less than 2 mL.
24. The method of claim 20 , wherein the monoclonal antibody is formulated at a concentration of at least 150 mg/mL.
25. The method of claim 20 , wherein the monoclonal antibody is administered in a volume of less than 2 mL.
26. The method of claim 1 , wherein the subject is human.
27. The method of claim 1 , wherein the monoclonal antibody is humanized.
28. A method of treating or reducing incidence of headache associated with the administration of a substance or its withdrawal in a subject, comprising administering to the subject a monthly dose of a monoclonal antibody that inhibits the calcitonin gene-related peptide (CGRP) pathway, wherein the monoclonal antibody comprises a CDR H1 as set forth in SEQ ID NO:3; a CDR H2 as set forth in SEQ ID NO:4; a CDR H3 as set forth in SEQ ID NO:5; a CDR L1 as set forth in SEQ ID NO:6; a CDR L2 as set forth in SEQ ID NO:7; and a CDR L3 as set forth in SEQ ID NO:8, wherein the amount administered monthly is about 225 mg, wherein the monoclonal antibody is formulated at a concentration of at least 150 mg/mL, and wherein the substance is an anti-headache medication.
29. The method of claim 28 , wherein the substance comprises ergot alkaloids, triptans, opioids, paracetamol, non-steroidal anti-inflammatory drugs, or a combination thereof.
30. The method of claim 28 , wherein the subject experiences 15 or more monthly headache days before said administering.
31. The method of claim 28 , wherein the administering is subcutaneous or intravenous administration.
32. The method of claim 28 , wherein the administering comprises utilizing a pre-filled syringe comprising the amount of the monoclonal antibody.
33. The method of claim 28 , wherein the monoclonal antibody is administered in a volume of about 1.5 mL.
34. The method of claim 28 , wherein the subject is human.
35. The method of claim 28 , wherein the monoclonal antibody is humanized.
36. A method of treating or reducing incidence of headache associated with the administration of a substance or its withdrawal in a subject, comprising administering to the subject a monthly dose of a monoclonal antibody that inhibits the calcitonin gene-related peptide (CGRP) pathway, wherein the monoclonal antibody comprises a CDR H1 as set forth in SEQ ID NO:3; a CDR H2 as set forth in SEQ ID NO:4; a CDR H3 as set forth in SEQ ID NO:5; a CDR L1 as set forth in SEQ ID NO:6; a CDR L2 as set forth in SEQ ID NO:7; and a CDR L3 as set forth in SEQ ID NO:8, wherein the amount administered monthly is about 675 mg, wherein the monoclonal antibody is formulated at a concentration of at least 150 mg/mL, and wherein the substance is an anti-headache medication.
37. The method of claim 36 , wherein the substance comprises ergot alkaloids, triptans, opioids, paracetamol, non-steroidal anti-inflammatory drugs, or a combination thereof.
38. The method of claim 36 , wherein the subject experiences 15 or more monthly headache days before said administering.
39. The method of claim 36 , wherein the administering is subcutaneous or intravenous administration.
40. The method of claim 36 , wherein the administering comprises utilizing a pre-filled syringe comprising the amount of the monoclonal antibody.
41. The method of claim 36 , wherein the monoclonal antibody is administered in a volume of about 1.5 mL.
42. The method of claim 36 , wherein the subject is human.
43. The method of claim 36 , wherein the monoclonal antibody is humanized.