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Anti-CGRP monoclonal antibodies in chronic migraine with medication overuse: real-life effectiveness and predictors of response at 6 months
被引:65
作者:

Caronna, Edoardo
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Univ Autonoma Barcelona, Hosp Univ Vall dHebron, Neurol Dept, Dept Med, Barcelona, Spain
Univ Autonoma Barcelona, Vall dHebron Res Inst, Dept Med, Headache & Neurol Pain Res Grp, Barcelona, Spain Univ Autonoma Barcelona, Hosp Univ Vall dHebron, Neurol Dept, Dept Med, Barcelona, Spain

Jose Gallardo, Victor
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Univ Autonoma Barcelona, Vall dHebron Res Inst, Dept Med, Headache & Neurol Pain Res Grp, Barcelona, Spain Univ Autonoma Barcelona, Hosp Univ Vall dHebron, Neurol Dept, Dept Med, Barcelona, Spain

Alpuente, Alicia
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Univ Autonoma Barcelona, Hosp Univ Vall dHebron, Neurol Dept, Dept Med, Barcelona, Spain
Univ Autonoma Barcelona, Vall dHebron Res Inst, Dept Med, Headache & Neurol Pain Res Grp, Barcelona, Spain Univ Autonoma Barcelona, Hosp Univ Vall dHebron, Neurol Dept, Dept Med, Barcelona, Spain

Torres-Ferrus, Marta
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Univ Autonoma Barcelona, Hosp Univ Vall dHebron, Neurol Dept, Dept Med, Barcelona, Spain
Univ Autonoma Barcelona, Vall dHebron Res Inst, Dept Med, Headache & Neurol Pain Res Grp, Barcelona, Spain Univ Autonoma Barcelona, Hosp Univ Vall dHebron, Neurol Dept, Dept Med, Barcelona, Spain

Pozo-Rosich, Patricia
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机构:
Univ Autonoma Barcelona, Hosp Univ Vall dHebron, Neurol Dept, Dept Med, Barcelona, Spain
Univ Autonoma Barcelona, Vall dHebron Res Inst, Dept Med, Headache & Neurol Pain Res Grp, Barcelona, Spain Univ Autonoma Barcelona, Hosp Univ Vall dHebron, Neurol Dept, Dept Med, Barcelona, Spain
机构:
[1] Univ Autonoma Barcelona, Hosp Univ Vall dHebron, Neurol Dept, Dept Med, Barcelona, Spain
[2] Univ Autonoma Barcelona, Vall dHebron Res Inst, Dept Med, Headache & Neurol Pain Res Grp, Barcelona, Spain
关键词:
Migraine;
Medication overuse;
CGRP;
Monoclonal antibodies;
Erenumab;
Galcanezumab;
PREVENTIVE TREATMENT;
SUBGROUP ANALYSIS;
DOUBLE-BLIND;
EFFICACY;
ERENUMAB;
SAFETY;
D O I:
10.1186/s10194-021-01328-1
中图分类号:
R74 [神经病学与精神病学];
学科分类号:
摘要:
Background In daily practice, anti-CGRP monoclonal antibodies (MAbs) may be useful in chronic migraine (CM) with medication overuse (MO), but data is limited. We evaluated their effectiveness in a real-life clinical cohort. Methods This is a prospective study conducted in CM patients with and without medication overuse treated with monthly MAbs during 6 months (erenumab/galcanezumab). We collected headache characteristics, including acute medication intake, through an electronic diary. We compared patients (1) with and without MO at baseline, (2) with and without ongoing MO after treatment, defining MO resolution as < 10 or 15 days/month of acute medication intake, according to analgesic type, during the 6-month treatment. Results Of 139 CM patients completing 6-month treatment with anti-CGRP MAbs, 71.2% (99/139) had MO at baseline. After 6 months, patients with and without MO at baseline had significant and similar proportions of >= 50% reduction in migraine days/month (MO: 63.6% vs. non-MO: 57.5%, p = 0.500). 60.6% (60/99) no longer satisfied MO definition. Reduction in headache frequency compared to baseline occurred in both MO-ongoing and MO-resolution group, although those who stopped overusing had a greater improvement (headache days/month: - 13.4 +/- 7.6 vs. -7.8 +/- 7.2, p < 0.0001). No differences in MO resolution were observed according to the MAbs used. Baseline lower pain severity was associated with MO resolution (OR [95%]:0.236[0.054-0.975]; p = 0.049). Conclusions In real-life anti-CGRP MAbs are as effective in CM patients with MO as in patients without it and facilitate MO cessation. Reduction in headache frequency and acute medication days/month occurs regardless of whether patients stop overusing or not.
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Univ Copenhagen, Fac Hlth & Med Sci, Dept Neurol, Danish Headache Ctr,Rigshosp Glostrup, Copenhagen, Denmark Univ Aquila, Neurosci Sect, Dept Appl Clin Sci & Biotechnol, Via Vetoio, I-67100 Laquila, Italy

Reuter, Uwe
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h-index: 0
机构:
Charite Univ Med Berlin, Dept Neurol, Berlin, Germany Univ Aquila, Neurosci Sect, Dept Appl Clin Sci & Biotechnol, Via Vetoio, I-67100 Laquila, Italy

Terwindt, Gisela
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h-index: 0
机构:
Leiden Univ, Dept Neurol, Med Ctr, Leiden, Netherlands Univ Aquila, Neurosci Sect, Dept Appl Clin Sci & Biotechnol, Via Vetoio, I-67100 Laquila, Italy

Mitsikostas, Dimos-Dimitrios
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机构:
Natl & Kapodistrian Univ Athens, Dept Neurol 1, Athens, Greece Univ Aquila, Neurosci Sect, Dept Appl Clin Sci & Biotechnol, Via Vetoio, I-67100 Laquila, Italy

Martelletti, Paolo
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机构:
Sapienza Univ, Dept Clin & Mol Med, Rome, Italy Univ Aquila, Neurosci Sect, Dept Appl Clin Sci & Biotechnol, Via Vetoio, I-67100 Laquila, Italy