Migraine Disability Improvement during Treatment with Galcanezumab in Patients with Chronic and High Frequency Episodic Migraine

Abstract

Background: The aim of the present study was to assess the migraine outcome, in particular migraine disability, in chronic (CM) and high frequency episodic migraine (HFEM) patients in treatment with galcanezumab. Methods: The present study was conducted at the Headache Centre of Spedali Civili of Brescia. Patients were treated with galcanezumab 120 mg monthly. Clinical and demographical information were collected at the baseline (T0). Data about outcome, analgesics consumption and disability (MIDAS and HIT-6 scores) were collected quarterly. Results: Fifty-four consecutive patients were enrolled. Thirty-seven patients had a diagnosis of CM, 17 of HFEM. During treatment, patients reported a significant reduction in terms of mean headache/migraine days (p < 0.001), the attacks’ pain intensity (p = 0.001) and monthly consumed analgesics (p < 0.001). The MIDAS and HIT-6 scores also documented a significant improvement (p < 0.001). At the baseline, all patients documented a severe degree of disability (MIDAS score ≥ 21). Following six months of treatment, only 29.2% of patients still documented a MIDAS score ≥ 21, with one third of patients documenting little or no disability. A > 50% MIDAS reduction, compared to baseline, was observed in up to 94.6% of patients, following the first three months of treatment. A similar outcome was found for HIT-6 scores. A significant positive correlation was found between headache days and MIDAS at T3 and T6 (T6 > T3), but not baseline. Discussion: Monthly prophylactic treatment with galcanezumab was found to be effective in both CM and HFEM, especially in reducing migraine burden and disability.

Effectiveness of galcanezumab on sleep quality, migraine outcome, and multidimensional patient-reported outcome measures: a real-world experience in Turkish patients with episodic and chronic migraine

“…The observed amelioration in MHDs and MMDs in our current study aligns with other real-world studies on galcanezumab, indicating a more extensive improvement in MHDs and MMDs than reported in randomized controlled trials RCTs ( 18 , 46 – 48 ). Notably, in both CM and EM patients, the correlation between MMDs and scores on the MIDAS and the HIT-6 was reported to be stronger during galcanezumab treatment than their correlation recorded at baseline.…”

“…Other real-world studies also indicated that monthly prophylactic treatment with galcanezumab was effective in both CM and EM, especially in reducing migraine burden and disability with significant improvements in several PROMs, including HIT-6, MIDAS, and MSQ ( 18 , 46 ). In this study, the median MIDAS scores started at 50.0 at baseline, then decreased to 9.0 by the 3rd month, indicating a shift from “severe disability” to “little or no/mild” disability.…”

“…Notably, in both CM and EM patients, the correlation between MMDs and scores on the MIDAS and the HIT-6 was reported to be stronger during galcanezumab treatment than their correlation recorded at baseline. This emphasizes the presence of treatment benefits extending beyond headache frequency to encompass more subtle aspects of the disease ( 46 , 49 , 50 ).…”

“…Disability in migraine patients is a multifaceted phenomenon influenced by personal functioning and the psychological burden of the disease, in addition to the number of headache days ( 46 ). In our patient cohort, BDI and BAI scores showed significant improvement following the galcanezumab loading dose, and this effect was sustained throughout the subsequent injection series.…”

Effects of Anti-CGRP Monoclonal Antibodies on Neurophysiological and Clinical Outcomes: A Combined Transcranial Magnetic Stimulation and Algometer Study

“…Migraine represents one of the most severe and prevalent brain conditions [ 1 ]. Its physiopathology is characterized by two opposing processes, habituation and sensitization, that together determine the cycle of a migraine attack [ 2 ].…”