RE-START : Exploring the effectiveness of anti-calcitonin gene-related peptide resumption after discontinuation in migraine
Romero del Rincón, Celia (Instituto de Investigación Sanitaria Princesa)
Gonzalez-Martinez, Alicia (Instituto de Investigación Sanitaria Princesa)
Quintas, Sonia (Instituto de Investigación Sanitaria Princesa)
Garcia Azorin, David (Hospital Clínico Universitario de Valladolid)
Fernández-Lázaro, Iris (Instituto de Investigación Sanitaria Princesa)
Guerrero Peral, Ángel Luis (Universidad de Valladolid)
Gonzalez Osorio, Yesica (Hospital Clínico Universitario de Valladolid)
Santos Lasaosa, Sonia (Hospital Clínico Universitario "Lozano Blesa" de Zaragoza)
González Oria, Carmen (Hospital Universitario Virgen del Rocío (Sevilla, Andalusia))
Sánchez Rodríguez, Norberto (Hospital Universitario Virgen del Rocío (Sevilla, Andalusia))
Iglesias Díez, Fernando (Headache Unit. Hospital Clínico Universitario de Burgos)
Echavarría Íñiguez, Ana (Hospital Clínico Universitario de Burgos)
Gil Luque, Sendoa (Hospital Clínico Universitario de Burgos)
Huerta, M. (Mariano) (Institut d'Investigació Biomèdica de Bellvitge)
Campoy Diaz, Sergio (Institut d'Investigació Biomèdica de Bellvitge)
Muñoz-Vendrell, Albert (Institut d'Investigació Biomèdica de Bellvitge)
Lozano Ros, Alberto (Hospital General Universitario Gregorio Marañón)
Sánchez-Soblechero, Antonio (Hospital General Universitario Gregorio Marañón)
Velasco Juanes, Fernando (Hospital Universitario de Cruces (Barakaldo, País Basc))
Kortazar-Zubizarreta, Izaro (Hospital de Álava)
Echeverría, Amaya (Hospital de Álava)
Rodríguez-Vico, Jaime (Hospital Universitario Fundación Jiménez Díaz)
Jaimes Sánchez, Alex (Hospital Universitario Fundación Jiménez Díaz)
Gómez García, Andrea (Hospital Universitario Fundación Jiménez Díaz)
Morollón Sánchez-Mateos, Noemí (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Belvís, Roberto (Institut de Recerca Sant Pau)
Navarro Pérez, María Pilar (Hospital Obispo Polanco (Terol, Aragó))
García-Moncó, Juan Carlos (Hospital Universitario de Basurto (Bilbao, Biscaia))
Álvarez Escudero, María Rocío (Hospital Universitario Central de Asturias)
Montes, Nuria (Universidad CEU San Pablo)
Gago-Veiga, Ana Beatriz (Instituto de Investigación Sanitaria Princesa)
Universitat Autònoma de Barcelona

Date:	2024
Abstract:	Background and purpose: According to the latest European guidelines, discontinuation of monoclonal antibodies against calcitonin gene-related peptide (anti-CGRP MAb) may be considered after 12-18 months of treatment. However, some patients may worsen after discontinuation. In this study, we assessed the response following treatment resumption. Methods: This was a prospective study conducted in 14 Headache Units in Spain. We included patients with response to anti-CGRP MAb with clinical worsening after withdrawal and resumption of treatment. Numbers of monthly migraine days (MMD) and monthly headache days (MHD) were obtained at four time points: before starting anti-CGRP MAb (T-baseline); last month of first treatment period (T-suspension); month of restart due to worsening (T-worsening); and 3 months after resumption (T-reintroduction). The response rate to resumption was calculated. Possible differences among periods were analysed according to MMD and MHD. Results: A total of 360 patients, 82% women, with a median (interquartile range [IQR]) age at migraine onset of 18 (12) years. The median (IQR) MHD at T-baseline was 20 (13) and MMD was 5 (6); at T-suspension, the median (IQR) MHD was 5 (6) and MMD was 4 (5); at T-worsening, the median (IQR) MHD was 16 (13) and MMD was 12 (6); and at T-reintroduction, the median (IQR) MHD was 8 (8) and MHD was 5 (5). In the second period of treatment, a 50% response rate was achieved by 57. 4% of patients in MHD and 65. 8% in MMD. Multivariate models showed significant differences in MHD between the third month after reintroduction and last month before suspension of first treatment period (p < 0. 001). Conclusion: The results suggest that anti-CGRP MAb therapy is effective after reintroduction. However, 3 months after resumption, one third of the sample reached the same improvement as after the first treatment period.
Grants:	Instituto de Salud Carlos III CM21/00178 Instituto de Salud Carlos III JR23/00005 Instituto de Salud Carlos III PMP22/00158
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	CGRP ; Effectiveness ; Migraine ; Response ; Resumption
Published in:	European Journal of Neurology, Vol. 31 Núm. 4 (april 2024) , p. e16203, ISSN 1468-1331

DOI: 10.1111/ene.16203
PMID: 38270379

10 p, 1.5 MB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut de Recerca Sant Pau
Articles > Research articles
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