Galcanezumab, a monoclonal antibody targeting the calcitonin gene-related peptide pathway (CGRP mAb), acts peripherally due to its large size. However, recent studies have suggested that CGRP mAbs may also have a central mode of action. This study aimed to evaluate the central effects of galcanezumab on migraine central sensitization.This prospective real-world study was conducted at three headache centers in Japan between May 2021 and May 2022. Patients treated with galcanezumab for migraines were included in the study. The primary outcome was the change in the validated Central Sensitization Inventory (CSI) score from baseline to six months of treatment. We also assessed changes in the Allodynia Symptom Checklist (ASC-12) score. Eighty-six patients with migraine (73 female and 13 male) were analyzed. At 6 months, CSI and ASC-12 scores were significantly reduced compared to baseline (CSI: 36.0 vs. 29.3, p < 0.001; and ASC-12: 5.55 vs. 4.26, p < 0.01). Furthermore, these effects were observed as early as three months of treatment. In this study, we demonstrated the real-world efficacy of galcanezumab in improving central sensitization in migraine, with significant effects seen in the early phase of treatment. Trial registration: This study was registered with UMIN-CTR on May 2, 2021 (UMIN000044096).
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| http://dx.doi.org/10.1038/s41598-024-72282-6 | DOI Listing |
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Article Synopsis
- Three monoclonal antibodies targeting calcitonin gene-related peptide (CGRP) are used in Japan for migraine treatment: galcanezumab, fremanezumab, and erenumab, with galcanezumab requiring two initial doses.
- This clinical study compares the early effectiveness of galcanezumab against fremanezumab and erenumab after initial treatment, along with various secondary outcomes related to headache frequency, medication usage, and overall improvement in symptoms.
- The research aims to clarify how these CGRP-mAbs differ in effectiveness and to assess the recurrence of headache symptoms after stopping treatment.
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