The recent approval of Erenumab and Fremanezumab is a breakthrough in the therapy of migraine since the approval of triptans, according to a review published in 'Expert Opinion on Emerging Drugs'. Migraine is ranked as the most disabling neurological disorder amongst the diseases worldwide under the age of 50 by the World Health Organization (WHO). Currently available are old,  poorly tolerated and not migraine-specific, pointing towards the low priority of migraine research and highlighting the vast unmet need in its management. The advancement in the understanding of migraine pathophysiological mechanisms and recognition of novel potentially important targets has led to a multitude of emerging acute and preventive treatments.

Giorgio Lambru et al. reviewed the known putative migraine pathophysiological mechanisms to understand the rationale of the most promising novel treatments targeting the Calcitonin-Gene-Related Peptide receptor and ligand and the 5 hydroxytryptamines (5-HT)1F receptor. The significant findings of phase II and phase III clinical trials on these treatments will be summarised. Also, critical analysis on failed trials of potentially essential targets, for example, the nitric oxide and the orexinergic pathways will be directed. The future outlook will be outlined.

"Several more studies are required to fully understand the clinical potential, long-term safety and cost-effectiveness of these therapies.