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 [1 ,2 ]
Jose Gallardo, Victor [2 ]
Alpuente, Alicia [1 ,2 ]
Torres-Ferrus, Marta [1 ,2 ]
Pozo-Rosich, Patricia [1 ,2 ]
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.
引用
收藏
页数:7
相关论文
共 15 条
[1]   Erenumab in the prevention of high-frequency episodic and chronic migraine: Erenumab in Real Life in Italy (EARLY), the first Italian multicenter, prospective real-life study [J].
Barbanti, Piero ;
Aurilia, Cinzia ;
Egeo, Gabriella ;
Fofi, Luisa ;
Cevoli, Sabina ;
Colombo, Bruno ;
Filippi, Massimo ;
Frediani, Fabio ;
Bono, Francesco ;
Grazzi, Licia ;
Salerno, Antonio ;
Mercuri, Bruno ;
Carnevale, Antonio ;
Altamura, Claudia ;
Vernieri, Fabrizio .
HEADACHE, 2021, 61 (02) :363-372
[2]   Safety, tolerability, and efficacy of TEV-48125 for preventive treatment of chronic migraine: a multicentre, randomised, double-blind, placebo-controlled, phase 2b study [J].
Bigal, Marcelo E. ;
Edvinsson, Lars ;
Rapoport, Alan M. ;
Lipton, Richard B. ;
Spierings, Egilius L. H. ;
Diener, Hans-Christoph ;
Burstein, Rami ;
Loupe, Pippa S. ;
Ma, Yuju ;
Yang, Ronghua ;
Silberstein, Stephen D. .
LANCET NEUROLOGY, 2015, 14 (11) :1091-1100
[3]   Comparison of 3 Treatment Strategies for Medication Overuse Headache A Randomized Clinical Trial [J].
Carlsen, Louise Ninett ;
Munksgaard, Signe Bruun ;
Nielsen, Mia ;
Engelstoft, Ida Maria Storm ;
Westergaard, Maria Lurenda ;
Bendtsen, Lars ;
Jensen, Rigmor Hojland .
JAMA NEUROLOGY, 2020, 77 (09) :1069-1078
[4]   Targeting calcitonin gene-related peptide: a new era in migraine therapy [J].
Charles, Andrew ;
Pozo-Rosich, Patricia .
LANCET, 2019, 394 (10210) :1765-1774
[5]   Galcanezumab in chronic migraine The randomized, double-blind, placebo-controlled REGAIN study [J].
Detke, Holland C. ;
Goadsby, Peter J. ;
Wang, Shufang ;
Friedman, Deborah I. ;
Selzler, Katherine J. ;
Aurora, Sheena K. .
NEUROLOGY, 2018, 91 (24) :E2211-E2221
[6]   Medication overuse in a subgroup analysis of phase 3 placebo-controlled studies of galcanezumab in the prevention of episodic and chronic migraine [J].
Dodick, David W. ;
Doty, Erin G. ;
Aurora, Sheena K. ;
Ruff, Dustin D. ;
Stauffer, Virginia L. ;
Jedynak, Jakub ;
Dong, Yan ;
Pearlman, Eric M. .
CEPHALALGIA, 2021, 41 (03) :340-352
[7]   Medication-overuse headache: epidemiology, diagnosis and treatment [J].
Kristoffersen, Espen Saxhaug ;
Lundqvist, Christofer .
THERAPEUTIC ADVANCES IN DRUG SAFETY, 2014, 5 (02) :87-99
[8]   Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition [J].
Olesen, Jes .
CEPHALALGIA, 2018, 38 (01) :1-211
[9]   Real-life data on the efficacy and safety of erenumab in the Abruzzo region, central Italy [J].
Ornello, Raffaele ;
Casalena, Alfonsina ;
Frattale, Ilaria ;
Gabriele, Amleto ;
Affaitati, Giannapia ;
Giamberardino, Maria Adele ;
Assetta, Maurizio ;
Maddestra, Maurizio ;
Marzoli, Fabio ;
Viola, Stefano ;
Cerone, Davide ;
Marini, Carmine ;
Pistoia, Francesca ;
Sacco, Simona .
JOURNAL OF HEADACHE AND PAIN, 2020, 21 (01)
[10]   European headache federation guideline on the use of monoclonal antibodies acting on the calcitonin gene related peptide or its receptor for migraine prevention [J].
Sacco, Simona ;
Bendtsen, Lars ;
Ashina, Messoud ;
Reuter, Uwe ;
Terwindt, Gisela ;
Mitsikostas, Dimos-Dimitrios ;
Martelletti, Paolo .
JOURNAL OF HEADACHE AND PAIN, 2019, 20 (1)