Real-world evidence following a mandatory treatment break after a 1-year prophylactic treatment with calcitonin gene-related peptide (pathway) monoclonal antibodies.
CGRP (pathway) antibodies
disease modification
guidelines
migraine
one-year prophylactic treatment
treatment break
Journal
Brain and behavior
ISSN: 2162-3279
Titre abrégé: Brain Behav
Pays: United States
ID NLM: 101570837
Informations de publication
Date de publication:
07 2022
07 2022
Historique:
revised:
10
05
2022
received:
29
04
2022
accepted:
13
05
2022
pubmed:
11
6
2022
medline:
26
7
2022
entrez:
10
6
2022
Statut:
ppublish
Résumé
Current German and European guidelines suggest migraine patients undertake a treatment break after 9 to 12 months of treatment with CGRP (pathway) monoclonal antibodies. Clinical routine data of highly resistant migraine patients were analyzed before treatment with CGRP monoclonal antibodies (baseline), after 12 months of treatment, and following a treatment break between November 2018 and December 2020 in the West German Headache Centre, University Hospital Essen, Germany. Monthly migraine days (MMD), monthly headache days (MHD), and days of acute medication intake (AMD) were assessed. Complete clinical data from 46 migraine patients (14 episodic migraine (EM), 32 chronic migraine (CM) patients) treated with erenumab (n = 40), galcanezumab (n = 4), and fremanezumab (n = 2) were analyzed. The mean number of MMDs among EM and CM patients after 12 months of CGRP antibody treatment increased during the treatment break by 5.18 (SE 0.92, p < .001) and 5.06 (SE 1.22, p = .003) days, respectively. There was an increased intake of acute medications among episodic (4.72, SE 0.87, p = .004) and chronic migraine patients (3.01, SE 1.08, p = .013) during treatment break. Eighty-three percent of patients (n = 38) were dissatisfied with the mandatory treatment break. All patients continued with a CGRP (pathway) monoclonal antibody after the mandatory treatment break. A mandatory break in CGRP (pathway) monoclonal antibody therapy had a negative short-term impact on migraine patients.
Sections du résumé
BACKGROUND
Current German and European guidelines suggest migraine patients undertake a treatment break after 9 to 12 months of treatment with CGRP (pathway) monoclonal antibodies.
METHODS
Clinical routine data of highly resistant migraine patients were analyzed before treatment with CGRP monoclonal antibodies (baseline), after 12 months of treatment, and following a treatment break between November 2018 and December 2020 in the West German Headache Centre, University Hospital Essen, Germany. Monthly migraine days (MMD), monthly headache days (MHD), and days of acute medication intake (AMD) were assessed.
RESULTS
Complete clinical data from 46 migraine patients (14 episodic migraine (EM), 32 chronic migraine (CM) patients) treated with erenumab (n = 40), galcanezumab (n = 4), and fremanezumab (n = 2) were analyzed. The mean number of MMDs among EM and CM patients after 12 months of CGRP antibody treatment increased during the treatment break by 5.18 (SE 0.92, p < .001) and 5.06 (SE 1.22, p = .003) days, respectively. There was an increased intake of acute medications among episodic (4.72, SE 0.87, p = .004) and chronic migraine patients (3.01, SE 1.08, p = .013) during treatment break. Eighty-three percent of patients (n = 38) were dissatisfied with the mandatory treatment break. All patients continued with a CGRP (pathway) monoclonal antibody after the mandatory treatment break.
CONCLUSION
A mandatory break in CGRP (pathway) monoclonal antibody therapy had a negative short-term impact on migraine patients.
Identifiants
pubmed: 35687795
doi: 10.1002/brb3.2662
pmc: PMC9304830
doi:
Substances chimiques
Antibodies, Monoclonal
0
Calcitonin Gene-Related Peptide Receptor Antagonists
0
Calcitonin Gene-Related Peptide
JHB2QIZ69Z
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e2662Informations de copyright
© 2022 The Authors. Brain and Behavior published by Wiley Periodicals LLC.
Références
J Headache Pain. 2019 Jun 3;20(1):66
pubmed: 31159727
Eur J Neurol. 2018 Aug;25(8):1069-e83
pubmed: 29617060
Cephalalgia. 2021 Oct;41(11-12):1181-1186
pubmed: 34000847
Cephalalgia. 2021 Apr;41(5):499-514
pubmed: 33626922
J Headache Pain. 2019 Jan 16;20(1):6
pubmed: 30651064
Lancet Neurol. 2007 Dec;6(12):1054-62
pubmed: 17988947
J Headache Pain. 2019 Dec 23;20(1):117
pubmed: 31870279
Neurol Sci. 2021 Aug;42(8):3297-3303
pubmed: 33389227
Neurol Clin Pract. 2021 Dec;11(6):e834-e839
pubmed: 34992966
Neurology. 2000 Sep 26;55(6):754-62
pubmed: 10993991
Am Fam Physician. 2019 Jan 1;99(1):17-24
pubmed: 30600979
Headache. 2019 Jun;59(6):834-847
pubmed: 30942898
J Headache Pain. 2020 Jul 3;21(1):84
pubmed: 32620151
Cephalalgia. 1991 Dec;11(6):251-6
pubmed: 1790569
Brain Behav. 2022 Jul;12(7):e2662
pubmed: 35687795
J Headache Pain. 2021 Dec 18;22(1):154
pubmed: 34922444
Cephalalgia. 1996 Aug;16(5):337-40
pubmed: 8869769
Cephalalgia. 2004;24 Suppl 1:9-160
pubmed: 14979299