Evaluating the efficacy of CGRP mAbs and gepants for the preventive treatment of migraine: A systematic review and network meta-analysis of phase 3 randomised controlled trials.


Journal

Cephalalgia : an international journal of headache
ISSN: 1468-2982
Titre abrégé: Cephalalgia
Pays: England
ID NLM: 8200710

Informations de publication

Date de publication:
04 2023
Historique:
entrez: 1 3 2023
pubmed: 2 3 2023
medline: 3 3 2023
Statut: ppublish

Résumé

Several novel treatments targeting the calcitonin gene-related peptide pathway have been developed for migraine. We evaluated the efficacy of these medications, including atogepant, rimegepant, erenumab, eptinezumab, fremanezumab, and galcanezumab, for the prevention of migraine via network meta-analysis. Databases, including MEDLINE via PubMed, EMBASE, and Cochrane central, were systematically reviewed, and all eligible phase 3 randomised controlled trials were included. Nineteen studies (n = 14,584 participants) were included. Studies included episodic (n = 11) and chronic (n = 4) migraine or both (n = 4). All interventions, except for eptinzumab 30 The results show that medications targeting calcitonin gene-related peptide were effective in preventing migraine compared to placebo. Considering limitations of single studies, different populations such as episodic and chronic migraine, and the absence of head-to-head trials, all novel treatments decreased mean monthly migraine and headache days, and showed higher 50%, 75% and 100% responder rates than placebo.

Sections du résumé

BACKGROUND
Several novel treatments targeting the calcitonin gene-related peptide pathway have been developed for migraine. We evaluated the efficacy of these medications, including atogepant, rimegepant, erenumab, eptinezumab, fremanezumab, and galcanezumab, for the prevention of migraine via network meta-analysis.
METHODS
Databases, including MEDLINE via PubMed, EMBASE, and Cochrane central, were systematically reviewed, and all eligible phase 3 randomised controlled trials were included.
RESULTS
Nineteen studies (n = 14,584 participants) were included. Studies included episodic (n = 11) and chronic (n = 4) migraine or both (n = 4). All interventions, except for eptinzumab 30
CONCLUSION
The results show that medications targeting calcitonin gene-related peptide were effective in preventing migraine compared to placebo. Considering limitations of single studies, different populations such as episodic and chronic migraine, and the absence of head-to-head trials, all novel treatments decreased mean monthly migraine and headache days, and showed higher 50%, 75% and 100% responder rates than placebo.

Identifiants

pubmed: 36855951
doi: 10.1177/03331024231159366
doi:

Substances chimiques

Calcitonin Gene-Related Peptide JHB2QIZ69Z
Calcitonin Gene-Related Peptide Receptor Antagonists 0

Types de publication

Meta-Analysis Systematic Review Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

3331024231159366

Auteurs

Faraidoon Haghdoost (F)

The George Institute for Global Health, University of New South Wales, Sydney, Australia.

Francesca Puledda (F)

Headache Group, Wolfson CARD, SLaM Biomedical Research Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, National Institute for Health Research-Wellcome Trust King's Clinical Research Facility, King's College Hospital, London, United Kingdom.

David Garcia-Azorin (D)

Headache Unit, Department of Neurology, Hospital Clínico Universitario de Valladolid, Gerencia Regional de Salud de Castilla y Leon, Valladolid, Spain.

Eva-Maria Huessler (EM)

Institute for Medical Informatics, Biometry and Epidemiology, University Hospital Essen, Germany.

Roberta Messina (R)

Neuroimaging Research Unit and Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.

Patricia Pozo-Rosich (P)

Headache Unit and Headache and Neurological Pain Research Group, Neurology Department, Hospital Universitari Vall d'Hebron and VHIR, Barcelona, Spain.

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Classifications MeSH