CGRP 抗体治疗耐药性偏头痛和慢性每日头痛患者：真实世界经验。
CGRP antibody therapy in patients with drug resistant migraine and chronic daily headache: a real-world experience.
机构信息
Department of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), West German Headache Center, University Hospital Essen, University Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany.
Department of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), Division of Clinical Neurooncology, University Hospital Essen, University Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany.
出版信息
J Headache Pain. 2021 Sep 20;22(1):111. doi: 10.1186/s10194-021-01323-6.
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.
背景
降钙素基因相关肽（CGRP）（受体）抗体（erenumab、fremanezumab 和 galcanezumab）越来越多地用于偏头痛的预防性治疗。在批准研究中，患有严重偏头痛和慢性每日头痛且没有任何无头痛日的患者被排除在外。因此，对于这一人群，CGRP 抗体治疗的有效性知之甚少。
方法
对 32 名偏头痛和每日头痛患者在接受 CGRP 抗体（16 例 erenumab、7 例 galcanezumab、9 例 fremanezumab）治疗三个月后的临床常规数据进行了分析，包括每月头痛天数（MHD）、每月偏头痛天数（MMD）和每月急性药物摄入（AMD）的变化以及偏头痛特征。采用 Wilcoxon 检验进行统计学分析。偏头痛特征采用描述性分析。
结果
MHD 的数量明显减少（平均减少（标准误差），p 值）：（-4.2（1.3），p=0.009）以及 MMD（-4.3（1.6），p=0.033）。4 名患者（13%）MHD 减少了 50%，8 名患者（25%）MMD 减少了 50%，偏头痛持续时间和强度在治疗下得到改善。
结论
尽管应答率较低，但 CGRP 抗体至少对一些药物难治性严重偏头痛和慢性每日头痛患者可能有效。
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