EFFICACY OF ANTI-CGRP MONOCLONAL ANTIBODIES IN CHRONIC MIGRAINE
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Keywords
Chronic Migraine, CGRP, Effectiveness, Monoclonal Antibodies, Prophylaxis.
Abstract
Background: Chronic migraine is an incapacitating neurological condition whose reaction toward standard prophylactic medicine is not very sufficient in a significant proportion of circumstances. Recently, monoclonal antibodies and CGRP have been identified as targeted therapy of migraine prophylaxis.
Objective: The current cross-sectional study aimed to evaluate efficacy of anti-CGRP monoclonal antibody in patients with chronic migraine.
Method: Cross-sectional study design was used to recruit 105 participants suffering from chronic migraine. Participants described 4 or more migraine attacks per month and exhibited previous failure of at least one prophylactic agent. Patients used either one of the four anti-CGRP anti-bodies that have been approved by FDA, for a period of 12 months. The main outcome consisted of alteration in monthly migraine days (MMDs). Secondary outcomes enclosed changes in MIDAS and HIT-6 results, acute medication use results, and patient satisfaction. Post- and pre-treatment comparisons were done by using paired t- tests.
Results: Mean age of participants was found to be 38.9 + 8.8 years, with 71.4% females. Significant improvement in the mean migration-related disability scores (MMDs) after three months of treatment (p < 0.001) was recorded having reduced to 7.4 + 2.9 as compared to 14.2 + 3.1 at baseline. The MMDs decreased by 50% or more among 65.7% of the participants. MIDAS score was reduced from 32.5 + 8.4 to 17.6 + 6.3 and the HIT-6 score decreased from 65.9 + 5.2 to 58.3 + 4.7 (p < 0.001). There was a reduction in acute exposure to medication (8.9 + 3.0 to 4.3 + 2.2 days/month) (p < 0.001). Lastly, 59 percent of sample demonstrated high satisfaction with the treatment plan.
Conclusion: Anti-calcitonin gene-related peptide (CGRP) monoclonal antibodies have proven to be effective in the reduction of migraine recurrence, functional impairment, and analgesic treatment in patients with chronic migraine.
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Maliha Ajmal
Locum Consultant, Somerset Foundation Trust, UK,
Minhal Javed
Medical Officer, Department of Medicine, Al-Mustafa Trust Hospital Lahore, Pakistan