Amylin Peptide in Migraine: A New Therapeutic Target Beyond CGRP

This was a narrative review of available evidence on amylin's role in migraine. The authors synthesized findings from provocation studies, biomarker research, preclinical animal studies, and pharmacological data on CGRP-targeting therapies that may also affect amylin receptors.

While CGRP-blocking drugs (like erenumab and fremanezumab) have transformed migraine care, about 40-50% of patients don't achieve adequate relief. If amylin represents an independent or overlapping migraine pathway, targeting it specifically could help non-responders. This is especially important because amylin and CGRP share receptor components, meaning some patients may benefit from dual blockade.

This review connects two major areas of peptide research: amylin biology (traditionally studied in diabetes/metabolism) and migraine neuroscience. The finding that amylin — best known for its role in blood sugar regulation — also participates in migraine pathophysiology illustrates how peptide signaling systems can have unexpected roles across different organs. It also suggests the migraine peptide story is more complex than CGRP alone.

The evidence base is still early-stage, with amylin's migraine role supported by limited clinical data (one biomarker study, provocation studies) and preclinical work. It's unclear whether targeting amylin independently of CGRP would be effective or safe. The review acknowledges that migraine is a complex disorder with many implicated molecules, and amylin may be one of several contributing pathways rather than a primary driver.