CGRP antibody therapy in patients with drug resistant migraine and chronic daily headache: a real-world experience

Abstract Background Calcitonin gene-related peptide (CGRP) (receptor) antibodies (erenumab, fremanezumab and galcanezumab) are increasingly used in prophylactic treatment of migraine. In the approval studies, severely affected patients with migraine and chronic daily headache without any headache fr...

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Main Authors: Armin Scheffler, Hannah Schenk, Sebastian Wurthmann, Michael Nsaka, Christoph Kleinschnitz, Martin Glas, Dagny Holle
Format: Article
Language:English
Published: BMC 2021-09-01
Series:The Journal of Headache and Pain
Subjects:
Online Access:https://doi.org/10.1186/s10194-021-01323-6
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spelling doaj-b731ecb7817c491b94df4ef044ea44d52021-09-26T11:48:43ZengBMCThe Journal of Headache and Pain1129-23691129-23772021-09-012211610.1186/s10194-021-01323-6CGRP antibody therapy in patients with drug resistant migraine and chronic daily headache: a real-world experienceArmin Scheffler0Hannah Schenk1Sebastian Wurthmann2Michael Nsaka3Christoph Kleinschnitz4Martin Glas5Dagny Holle6Department of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), West German Headache Center, University Hospital Essen, University Duisburg-EssenDepartment of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), West German Headache Center, University Hospital Essen, University Duisburg-EssenDepartment of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), West German Headache Center, University Hospital Essen, University Duisburg-EssenDepartment of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), West German Headache Center, University Hospital Essen, University Duisburg-EssenDepartment of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), West German Headache Center, University Hospital Essen, University Duisburg-EssenDepartment of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), Division of Clinical Neurooncology, University Hospital Essen, University Duisburg-EssenDepartment of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), West German Headache Center, University Hospital Essen, University Duisburg-EssenAbstract Background Calcitonin gene-related peptide (CGRP) (receptor) antibodies (erenumab, fremanezumab and galcanezumab) are increasingly used in prophylactic treatment of migraine. In the approval studies, severely affected patients with migraine and chronic daily headache without any headache free days were excluded. Thus, less is known about the effectiveness of CGRP antibody treatment in this cohort. Methods Clinical routine data of 32 patients with migraine and daily headache were analysed after three months of treatment with a CGRP antibody (16 erenumab, 7 galcanezumab, 9 fremanezumab), including changes of monthly headache days (MHD) monthly migraine days (MMD) and monthly acute medication intake (AMD) as well as migraine characteristics. Statistical analysis was performed with the Wilcoxon-Test. Migraine characteristics were analysed descriptively. Results The number of MHD was significantly reduced (mean reduction (standard error), p-value): (-4.2 (1.3), p = 0.009) as well as MMD (-4.3 (1.6), p = 0.033). Four patients (13 %) reached a 50 % reduction regarding MHD and 8 patients (25 %) regarding MMD, migraine duration and intensity improved under therapy. Conclusions Despite the low responder rate, CGRP antibodies can be effective at least in a few cases of severely affected patients with drug resistant migraine and chronic daily headache. Trial registration Retrospective registered.https://doi.org/10.1186/s10194-021-01323-6MigraineCGRP antibodyTherapyReal-worldChronic daily headache
collection DOAJ
language English
format Article
sources DOAJ
author Armin Scheffler
Hannah Schenk
Sebastian Wurthmann
Michael Nsaka
Christoph Kleinschnitz
Martin Glas
Dagny Holle
spellingShingle Armin Scheffler
Hannah Schenk
Sebastian Wurthmann
Michael Nsaka
Christoph Kleinschnitz
Martin Glas
Dagny Holle
CGRP antibody therapy in patients with drug resistant migraine and chronic daily headache: a real-world experience
The Journal of Headache and Pain
Migraine
CGRP antibody
Therapy
Real-world
Chronic daily headache
author_facet Armin Scheffler
Hannah Schenk
Sebastian Wurthmann
Michael Nsaka
Christoph Kleinschnitz
Martin Glas
Dagny Holle
author_sort Armin Scheffler
title CGRP antibody therapy in patients with drug resistant migraine and chronic daily headache: a real-world experience
title_short CGRP antibody therapy in patients with drug resistant migraine and chronic daily headache: a real-world experience
title_full CGRP antibody therapy in patients with drug resistant migraine and chronic daily headache: a real-world experience
title_fullStr CGRP antibody therapy in patients with drug resistant migraine and chronic daily headache: a real-world experience
title_full_unstemmed CGRP antibody therapy in patients with drug resistant migraine and chronic daily headache: a real-world experience
title_sort cgrp antibody therapy in patients with drug resistant migraine and chronic daily headache: a real-world experience
publisher BMC
series The Journal of Headache and Pain
issn 1129-2369
1129-2377
publishDate 2021-09-01
description Abstract Background Calcitonin gene-related peptide (CGRP) (receptor) antibodies (erenumab, fremanezumab and galcanezumab) are increasingly used in prophylactic treatment of migraine. In the approval studies, severely affected patients with migraine and chronic daily headache without any headache free days were excluded. Thus, less is known about the effectiveness of CGRP antibody treatment in this cohort. Methods Clinical routine data of 32 patients with migraine and daily headache were analysed after three months of treatment with a CGRP antibody (16 erenumab, 7 galcanezumab, 9 fremanezumab), including changes of monthly headache days (MHD) monthly migraine days (MMD) and monthly acute medication intake (AMD) as well as migraine characteristics. Statistical analysis was performed with the Wilcoxon-Test. Migraine characteristics were analysed descriptively. Results The number of MHD was significantly reduced (mean reduction (standard error), p-value): (-4.2 (1.3), p = 0.009) as well as MMD (-4.3 (1.6), p = 0.033). Four patients (13 %) reached a 50 % reduction regarding MHD and 8 patients (25 %) regarding MMD, migraine duration and intensity improved under therapy. Conclusions Despite the low responder rate, CGRP antibodies can be effective at least in a few cases of severely affected patients with drug resistant migraine and chronic daily headache. Trial registration Retrospective registered.
topic Migraine
CGRP antibody
Therapy
Real-world
Chronic daily headache
url https://doi.org/10.1186/s10194-021-01323-6
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