Treatment of resistant chronic migraine with anti-CGRP monoclonal antibodies: a systematic review

Sevivas, Hugo; Fresco, Paula

doi:10.1186/s40001-022-00716-w

Cited by 24 publications

(17 citation statements)

References 97 publications

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“…A systematic review which was conducted to evaluate the treatment of resistant chronic migraine with anti-CGRP monoclonal antibodies mentions that developing tachyphylaxis is possible. This could be due to an increased development of antibodies in response to treatment [14].…”

Section: Discussionmentioning

confidence: 99%

Effectiveness, and Safety of Eptinezumab in Episodic and Chronic Migraine Headache in the UAE: A retrospective study

Bader¹,

Suliman²,

Harb³

et al. 2023

Preprint

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Background Eptinezumab-jjmr is a humanized IgG1 immunoglobulin monoclonal antibody administered intravenously as a preventative migraine treatment. Previously conducted randomized, double-blind, placebo-controlled trials exhibited significant reduction in monthly migraine frequency among adults experiencing episodic and chronic migraine. The present study seeks to expand upon the current findings and evaluate Eptinezumab-jjmr’s efficacy as a preventative migraine treatment for chronic and episodic migraine patients in the United Arab Emirates. This study is intended to represent the first real-world evidence study and will hopefully serve as a valuable complement to the existing literature on the subject.Methods This was a retrospective, observational, and exploratory study. The participants included within the study were adult (≥ 18 years) patients diagnosed with either episodic or chronic migraine. Patients were categorized according to their history of previous preventative treatment failure. For the final assessment of treatment efficacy, we included only patients with a minimum of 6 months of clinical follow-up data. Patients were assessed at baseline for their monthly migraine frequency and assessed again at months 3 and 6. The primary objective was to evaluate the efficacy of Eptinezumab-jjmr in reducing migraine frequency among chronic and episodic migraine patients.Results 100 participants were identified, of whom 53 patients completed the study protocol to month 6. 40 (75.5%) were female, 46 (86.8%) were Emirati locals, and 16 (30.2%) were pharmaceutically naïve, having never tried any prior preventative therapy. Additionally, 25 (47.2%) patients met the criteria for chronic migraine (CM), whereas the remaining 28 (52.8%) were diagnosed with episodic migraine (EM). The baseline monthly migraine frequency (MMD) was 12.2 (4.97) days across all participants, 15.6 (3.97) for CM patients, and 9.25 (3.76) for EM patients; by month 6, these frequencies reduced to 3.66 (4.21), 4.76 (5.32), and 2.68 (2.61), respectively. Overall, 58.5% of those enrolled experienced > 75% reduction in MMD frequency by month 6.Conclusion Patients enrolled in this trial experienced clinically significant reductions in MMD by month 6. Eptinezumab-jjmr was well tolerated with only one AE of note.

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Section: Discussionmentioning

confidence: 99%

Effectiveness, and Safety of Eptinezumab in Episodic and Chronic Migraine Headache in the UAE: A retrospective study

Bader¹,

Suliman²,

Harb³

et al. 2023

Preprint

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“…Fortunately, with the advent of new data on drug therapy in migraine, this era is also witnessing a remarkable change in its management[ 41 ]. Recent studies have shown mechanism-based therapies like anti-calcitonin gene-related peptide monoclonal antibodies (erenumab, tinezumab, fremanezumab and galcanezumabas) as promising drugs in the preventive management of migraine[ 13 , 42 ]. In addition to rapid onset, these drugs also carry fewer adverse effects (mainly injection site reactions).…”

Section: Discussionmentioning

confidence: 99%

Migraine in physicians and final year medical students: A cross-sectional insight into prevalence, self-awareness, and knowledge from Pakistan

Choudry¹,

Ata²,

Alam³

et al. 2022

WJM

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BACKGROUND Despite its high prevalence, migraine remains underdiagnosed worldwide. A significant reason is the knowledge gap in physicians regarding diagnostic criteria, clinical features, and other clinical aspects of migraine. AIM To measure the knowledge deficit in physicians and medical students and to assess the prevalence of migraine in the same population. METHODS An online questionnaire was developed and distributed among physicians and final year medical students on duty in various medical and surgical specialties of Allied and DHQ Hospitals, Faisalabad, between October 2018 and October 2019. Inclusion criteria were public practicing physicians who experience headaches, while those who never experienced headaches were excluded. Different questions assessed respondents on their knowledge of triggers, diagnosis, management, and prophylaxis of the migraine headache. They were asked to diagnose themselves using embedded ICHD-3 diagnostic criteria for different types of migraine. Graphs, tables, and figures were made using Microsoft Office 2016 and Microsoft Visio, and data analysis was done in R Studio 1.4. RESULTS We had 213 respondents and 175 fulfilled inclusion criteria, with 99 (52%), 58 (30%) and 12 (6.3%) belonging to specialties of medicine, surgery, and others, respectively. Both genders were symmetrically represented (88 male and 87 female). Fifty-two (24.4%) of our 213 respondents were diagnosed with migraine, with 26 (50%) being aware of it. Females had higher prevalence among study participants ( n = 28, 32.2%) compared to males ( n = 20, 22.7%, P = 0.19). A majority (62%) of subjects never consulted any doctor for their headache. Similarly, a majority (62%) either never heard or did not remember the diagnostic criteria of migraine. Around 38% falsely believed that having any type of aura is essential for diagnosing migraine. The consultation rate was 37% ( n = 65), and migraineurs were significantly more likely to have consulted a doctor, and a neurologist in particular ( P < 0.001). Consulters and migraineurs fared better in the knowledge of diagnostic aspects of the disease than their counterparts. There was no significant difference in other knowledge aspects between consulters versus non-consulters and migraineurs versus non-migraineurs. CONCLUSION Critical knowledge gaps exist between physicians and medical students, potentially contributing to misdiagnosis and mismanagement of migraine.

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“…The development and use of monoclonal antibodies directed against the neuropeptide CGRP or its receptor are the most recent achievement in the field of migraine [ 287 ]. However, despite the success displayed by such monoclonal antibodies, there is still a great percentage of migraine patients for whom the beneficial effects are minimal or completely absent, which underscores the involvement of other biological players in migraine generation and maintenance besides CGRP [ 288 , 289 , 290 ]. An important role is played by NO.…”

Section: Fitting Together the Pieces Of A Complex Picturementioning

confidence: 99%

Biomarkers of Migraine: An Integrated Evaluation of Preclinical and Clinical Findings

Demartini

Francavilla

Zanaboni

et al. 2023

IJMS

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In recent years, numerous efforts have been made to identify reliable biomarkers useful in migraine diagnosis and progression or associated with the response to a specific treatment. The purpose of this review is to summarize the alleged diagnostic and therapeutic migraine biomarkers found in biofluids and to discuss their role in the pathogenesis of the disease. We included the most informative data from clinical or preclinical studies, with a particular emphasis on calcitonin gene-related peptide (CGRP), cytokines, endocannabinoids, and other biomolecules, the majority of which are related to the inflammatory aspects and mechanisms of migraine, as well as other actors that play a role in the disease. The potential issues affecting biomarker analysis are also discussed, such as how to deal with bias and confounding data. CGRP and other biological factors associated with the trigeminovascular system may offer intriguing and novel precision medicine opportunities, although the biological stability of the samples used, as well as the effects of the confounding role of age, gender, diet, and metabolic factors should be considered.

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Treatment of resistant chronic migraine with anti-CGRP monoclonal antibodies: a systematic review

Cited by 24 publications

References 97 publications

Effectiveness, and Safety of Eptinezumab in Episodic and Chronic Migraine Headache in the UAE: A retrospective study

Effectiveness, and Safety of Eptinezumab in Episodic and Chronic Migraine Headache in the UAE: A retrospective study

Migraine in physicians and final year medical students: A cross-sectional insight into prevalence, self-awareness, and knowledge from Pakistan

Biomarkers of Migraine: An Integrated Evaluation of Preclinical and Clinical Findings

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