Anti-CGRP monoclonal antibodies in chronic migraine with medication overuse : real-life effectiveness and predictors of response at 6 months
Caronna, Edoardo (Vall d'Hebron Institut de Recerca (VHIR))
Gallardo López, Victor José (Vall d'Hebron Institut de Recerca (VHIR))
Alpuente, Alicia (Vall d'Hebron Institut de Recerca (VHIR))
Torres-Ferrús, Marta (Vall d'Hebron Institut de Recerca (VHIR))
Pozo-Rosich, Patricia (Vall d'Hebron Institut de Recerca (VHIR))
Universitat Autònoma de Barcelona

Fecha:	2021
Resumen:	Background: In daily practice, anti-CGRP monoclonal antibodies (MAbs) may be useful in chronic migraine (CM) with medication overuse (MO), but data is limited. We evaluated their effectiveness in a real-life clinical cohort. Methods: This is a prospective study conducted in CM patients with and without medication overuse treated with monthly MAbs during 6 months (erenumab/galcanezumab). We collected headache characteristics, including acute medication intake, through an electronic diary. We compared patients (1) with and without MO at baseline, (2) with and without ongoing MO after treatment, defining MO resolution as < 10 or 15 days/month of acute medication intake, according to analgesic type, during the 6-month treatment. Results: Of 139 CM patients completing 6-month treatment with anti-CGRP MAbs, 71. 2% (99/139) had MO at baseline. After 6 months, patients with and without MO at baseline had significant and similar proportions of ≥50% reduction in migraine days/month (MO: 63. 6% vs. non-MO: 57. 5%, p = 0. 500). 60. 6% (60/99) no longer satisfied MO definition. Reduction in headache frequency compared to baseline occurred in both MO-ongoing and MO-resolution group, although those who stopped overusing had a greater improvement (headache days/month: - 13. 4 ± 7. 6 vs. -7. 8 ± 7. 2, p < 0. 0001). No differences in MO resolution were observed according to the MAbs used. Baseline lower pain severity was associated with MO resolution (OR [95%]:0. 236[0. 054-0. 975]; p = 0. 049). Conclusions: In real-life anti-CGRP MAbs are as effective in CM patients with MO as in patients without it and facilitate MO cessation. Reduction in headache frequency and acute medication days/month occurs regardless of whether patients stop overusing or not.
Nota:	Dr. Caronna has received honoraria from Novartis and Chiesi. Mr. Gallardo reports no disclosures. Dr. Alpuente has received honoraria from Allergan-AbbVie, Novartis, Chiesi. Dr. Torres-Ferrus has received honoraria from Allergan-AbbVie, Novartis, Chiesi and Teva. Dr. Pozo-Rosich has received honoraria as a consultant and speaker for: Allergan-AbbVie, Almirall, Biohaven, Chiesi, Eli Lilly, Medscape, Neurodiem, Novartis and Teva. Her research group has received research grants from Novartis; has received funding for clinical trials from Alder, Amgen, Electrocore, Eli Lilly, Novartis, Teva. She is a trustee member of the board of the International Headache Society and the Council of the European Headache Federation. She is in the editorial board of Revista de Neurologia. She is an editor for Cephalalgia, Headache, Neurologia, Frontiers of Neurology and and advisor for The Journal of Headache and Pain. She is a member of the Clinical Trials Guidelines Committee of the International Headache Society. She has edited the Guidelines for the Diagnosis and Treatment of Headache of the Spanish Neurological Society. She is the founder of www.midolordecabeza.org. PP-R does not own stocks from any pharmaceutical company.
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Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Publicado en:	Journal of headache and pain, Vol. 22 Núm. 1 (december 2021) , p. 120, ISSN 1129-2377

DOI: 10.1186/s10194-021-01328-1
PMID: 34620085

7 p, 874.5 KB

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