Objective: We sought to assess the safety and tolerability of 3 calcitonin gene-related peptide (CGRP) monoclonal antibodies in patients with chronic migraine who have failed multiple classes of migraine preventive therapies.
Background: CGRP is an important neuromodulator implicated in the pathogenesis of migraine. They are approved for the treatment of episodic and chronic migraine. In current clinical practice, CGRP monoclonal antibodies are used in patients who have failed multiple preventive agents, but safety, tolerability, and efficacy have not been well described in real-world populations outside of clinical trials.
Methods: This was a single-center, observational, retrospective study in adults with chronic migraine treated with a CGRP monoclonal antibody between May 1, 2018 and September 30, 2019. Charts were reviewed at 0, 3, and 6 months after treatment.
Results: From May 1, 2018 to September 30, 2019, 77 patients with chronic migraine were prescribed 90 treatment trials of a CGRP monoclonal antibody. Patients reported adverse outcomes in 2/5 (40.0%) with erenumab 70 mg, 32/46 (69.6%) with erenumab 140 mg, 8/16 (50.0%) with fremanezumab, and 15/23 (65.2%) with galcanezumab. The most frequent adverse effects were constipation and injection site reactions. Adverse effects leading to discontinuation were reported as follows: erenumab 70 mg 1/5 (20.0%), erenumab 140 mg 10/46 (22.7%), fremanezumab 1/16 (6.3%), and galcanezumab 1/23 (4.3%), with 13/90 (14.4%) discontinuation rate overall. The most frequent reasons for discontinuation were lack of improvement in 17/90 (18.9%) and constipation in 4/90 (4.4%). A 50% or greater reduction in the number of severe headache days per month was achieved for 32/66 (48.5%) at 3 months and 17/48 (35.4%) at 6 months.
Conclusions: In patients with chronic migraine, the 3 CGRP monoclonal antibodies were well tolerated, and reduced the number of severe headache days.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1111/head.13956 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Treating episodic migraine with precision: the evolving landscape of targeted therapies driven by insights in disease biology.
Expert Opin Biol Ther
January 2025
University Medicine Greifswald, Greifswald, Germany.
Introduction: Migraine is a disabling neurological disorder with a complex neurobiology. It appears as a cyclic disorder of sensory processing, affecting multiple systems beyond nociception. Overlapping mechanisms, including dysfunctional processing of sensory input from brain structures are involved in the generation of attacks.
View Article and Find Full Text PDFTreatment Patterns, Characteristics, and Probable Acute Medication Overprescription Among Patients With Migraine in Japan: A Retrospective Cross-Sectional and Longitudinal Analysis of Health Insurance Claims Data.
Cureus
December 2024
Department of Surgery, Itoigawa General Hospital, Itoigawa, JPN.
Objective This study aimed to investigate prescription patterns for migraine patients aged 18 years and older using the REZULT database, managed by Japan System Techniques Co., Ltd. in Tokyo, Japan.
View Article and Find Full Text PDFPharmacological differences and switching among anti-CGRP monoclonal antibodies: A narrative review.
Headache
January 2025
Section of Clinical Pharmacology and Oncology, Department of Health Sciences, University of Florence, Florence, Italy.
Antibodies targeting either the calcitonin gene-related peptide (CGRP), such as galcanezumab, fremanezumab, and eptinezumab, or the receptor (erenumab) have been approved for the prevention of episodic and chronic migraine. Although widely used and generally effective, a proportion of patients discontinue treatment due to lack of efficacy. In both randomized controlled trials and observational studies, all anti-CGRP monoclonal antibodies (mAbs) have consistently demonstrated comparable efficacy and tolerability, suggesting a pharmacological class effect.
View Article and Find Full Text PDFMedication underuse in real-life practice: the impact of galcanezumab towards achieving very low frequency episodic migraine in a southeast Asian middle-income nation.
J Headache Pain
January 2025
Department of Neurology, The David Geffen School of Medicine at UCLA, Los Angeles, USA.
Background: Migraine progression, particularly from episodic to chronic migraine (CM), increases disease burden and healthcare costs. Understanding the new concept of "Medication Underuse Headache" should encourage the health care provider to consider early intervention with calcitonin gene-related peptide (CGRP) monoclonal antibodies. Galcanezumab given early in the course of the disease, may prevent migraine chronification and have a robust response, moreso than when initiated in later stages of migraine.
View Article and Find Full Text PDFAdvances in Migraine Treatment: A Comprehensive Clinical Review.
Curr Protein Pept Sci
January 2025
Department of Pharmacology, SRM College of Pharmacy, SRM Institute of Science and Technology, Kattankulathur- 603203, Chengalpattu, Tamil Nadu, India.
Migraine is a neurological disease that, while not inherently causing "chronic headaches," can evolve into a chronic condition over time including major symptoms such as nausea, and light, sound, and allodynia, particularly in cases of frequent episodic migraine or due to factors such as medication overuse or inadequate management. This condition's complex pathophysiology makes treatment difficult. Genetics, trigeminovascular system activation, and cortical spreading depression are involved.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!