Redefining migraine prevention: early treatment with anti-CGRP monoclonal antibodies enhances response in the real world

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Caronna, Edoardo (author)

Redefining migraine prevention: early treatment with anti-CGRP monoclonal antibodies enhances response in the real world

Article/chapterEnglish2024

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2024

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LIBRIS-ID:oai:gup.ub.gu.se/339737
https://gup.ub.gu.se/publication/339737URI
https://doi.org/10.1136/jnnp-2023-333295DOI

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Language:English

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SwePubSwePub

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Subject category:ref swepub-contenttype
Subject category:art swepub-publicationtype

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Background Anti-CGRP monoclonal antibodies (anti-CGRP MAbs) are approved and available treatments for migraine prevention. Patients do not respond alike and many countries have reimbursement policies, which hinder treatments to those who might respond. This study aimed to investigate clinical factors associated with good and excellent response to anti-CGRP MAbs at 6 months. Methods European multicentre, prospective, real-world study, including high-frequency episodic or chronic migraine (CM) patients treated since March 2018 with anti-CGRP MAbs. We defined good and excellent responses as >= 50% and >= 75% reduction in monthly headache days (MHD) at 6 months, respectively. Generalised mixed-effect regression models (GLMMs) were used to identify variables independently associated with treatment response. Results Of the 5818 included patients, 82.3% were females and the median age was 48.0 (40.0-55.0) years. At baseline, the median of MHD was 20.0 (14.0-28.0) days/months and 72.2% had a diagnosis of CM. At 6 months (n=4963), 56.5% (2804/4963) were good responders and 26.7% (1324/4963) were excellent responders. In the GLMM model, older age (1.08 (95% CI 1.02 to 1.15), p=0.016), the presence of unilateral pain (1.39 (95% CI 1.21 to 1.60), p<0.001), the absence of depression (0.840 (95% CI 0.731 to 0.966), p=0.014), less monthly migraine days (0.923 (95% CI 0.862 to 0.989), p=0.023) and lower Migraine Disability Assessment at baseline (0.874 (95% CI 0.819 to 0.932), p<0.001) were predictors of good response (AUC of 0.648 (95% CI 0.616 to 0.680)). These variables were also significant predictors of excellent response (AUC of 0.691 (95% CI 0.651 to 0.731)). Sex was not significant in the GLMM models. Conclusions This is the largest real-world study of migraine patients treated with anti-CGRP MAbs. It provides evidence that higher migraine frequency and greater disability at baseline reduce the likelihood of responding to anti-CGRP MAbs, informing physicians and policy-makers on the need for an earlier treatment in order to offer the best chance of treatment success.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Neurologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Neurology hsv//eng
migraine
health policy & practice

Added entries (persons, corporate bodies, meetings, titles ...)

Gallardo, Victor Jose (author)
Egeo, Gabriella (author)
Vazquez, Manuel Millan (author)
Castellanos, Candela Nieves (author)
Membrilla, Javier A. (author)
Vaghi, Gloria (author)
Rodriguez-Montolio, Joana (author)
Fabra, Neus Fabregat (author)
Sanchez-Caballero, Francisco (author)
Sanchez, Alex Jaimes (author)
Munoz-Vendrell, Albert (author)
Oliveira, Renato (author)
Garate, Gabriel (author)
Gonzalez-Osorio, Yesica (author)
Guisado-Alonso, Daniel (author)
Ornello, Raffaele (author)
Thunstedt, Cem (author)
Fernandez-Lazaro, Iris (author)
Torres-Ferrus, Marta (author)
Alpuente, Alicia (author)
Torelli, Paola (author)
Aurilia, Cinzia (author)
Pere, Raquel Lamas (author)
Castrillo, Maria Jose Ruiz (author)
De Icco, Roberto (author)
Sances, Grazia (author)
Broadhurst, Sarah (author)
Ong, Hui Ching (author)
Garcia, Andrea Gomez (author)
Campoy, Sergio (author)
Sanahuja, Jordi (author)
Cabral, Goncalo (author)
Blasco, Isabel Beltran (author)
Waliszewska-Prosol, Marta (author)
Pereira, Liliana (author)
Layos-Romero, Almudena (author)
Luzeiro, Isabel (author)
Dorado, Laura (author)
Escudero, Maria Rocio Alvarez (author)
May, Arne (author)
Lopez-Bravo, Alba (author)
Martins, Isabel Pavao (author)
Sundal, ChristinaGothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi, sektionen för klinisk neurovetenskap,Institute of Neuroscience and Physiology, Department of Clinical Neuroscience(Swepub:gu)xsuchr (author)
Irimia, Pablo (author)
Ros, Alberto Lozano (author)
Gago-Veiga, Ana Beatriz (author)
Juanes, Fernando Velasco (author)
Ruscheweyh, Ruth (author)
Sacco, Simona (author)
Cuadrado-Godia, Elisa (author)
Garcia-Azorin, David (author)
Pascual, Julio (author)
Gil-Gouveia, Raquel (author)
Huerta-Villanueva, Mariano (author)
Rodriguez-Vico, Jaime (author)
Romero, Javier Viguera (author)
Obach, Victor (author)
Santos-Lasaosa, Sonia (author)
Ghadiri-Sani, Mona (author)
Tassorelli, Cristina (author)
Diaz-de-Teran, Javier (author)
Insa, Samuel Diaz (author)
Oria, Carmen Gonzalez (author)
Barbanti, Piero (author)
Pozo-Rosich, Patricia (author)
Göteborgs universitetInstitutionen för neurovetenskap och fysiologi, sektionen för klinisk neurovetenskap (creator_code:org_t)

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In:JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY0022-30501468-330X

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By the author/editor: Caronna, Edoardo; Gallardo, Victor ...; Egeo, Gabriella; Vazquez, Manuel ...; Castellanos, Can ...; Membrilla, Javie ...; show more...; Vaghi, Gloria; Rodriguez-Montol ...; Fabra, Neus Fabr ...; Sanchez-Caballer ...; Sanchez, Alex Ja ...; Munoz-Vendrell, ...; Oliveira, Renato; Garate, Gabriel; Gonzalez-Osorio, ...; Guisado-Alonso, ...; Ornello, Raffael ...; Thunstedt, Cem; Fernandez-Lazaro ...; Torres-Ferrus, M ...; Alpuente, Alicia; Torelli, Paola; Aurilia, Cinzia; Pere, Raquel Lam ...; Castrillo, Maria ...; De Icco, Roberto; Sances, Grazia; Broadhurst, Sara ...; Ong, Hui Ching; Garcia, Andrea G ...; Campoy, Sergio; Sanahuja, Jordi; Cabral, Goncalo; Blasco, Isabel B ...; Waliszewska-Pros ...; Pereira, Liliana; Layos-Romero, Al ...; Luzeiro, Isabel; Dorado, Laura; Escudero, Maria ...; May, Arne; Lopez-Bravo, Alb ...; Martins, Isabel ...; Sundal, Christin ...; Irimia, Pablo; Ros, Alberto Loz ...; Gago-Veiga, Ana ...; Juanes, Fernando ...; Ruscheweyh, Ruth; Sacco, Simona; Cuadrado-Godia, ...; Garcia-Azorin, D ...; Pascual, Julio; Gil-Gouveia, Raq ...; Huerta-Villanuev ...; Rodriguez-Vico, ...; Romero, Javier V ...; Obach, Victor; Santos-Lasaosa, ...; Ghadiri-Sani, Mo ...; Tassorelli, Cris ...; Diaz-de-Teran, J ...; Insa, Samuel Dia ...; Oria, Carmen Gon ...; Barbanti, Piero; Pozo-Rosich, Pat ...; show less...

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