Clinical Edge Journal Scan

Real-world predictors of response to anti-CGRP mAb in migraine


 

Key clinical point: Migraine pain characteristics indicating peripheral or central sensitization may help predict 50% response to anti-calcitonin gene-related peptide (anti-CGRP) monoclonal antibodies (mAb) in patients with high frequency episodic migraine (HFEM) or chronic migraine (CM).

Major finding: In HFEM, unilateral pain (UP) + unilateral cranial autonomic symptoms (UA) positively predicted 50% response (odds ratio [OR] 4.23; P = .004), whereas in CM, UP (OR 1.46; P = .039), UA (OR 1.49; P = .026), UP+UA (OR 1.90; P = .012), and UP+allodynia (OR 1.71; P = .034) positively predicted 50% response and obesity negatively predicted 50% response (OR 0.21; P = .006).

Study details: This was a real-life prospective cohort study including 864 anti-CGRP mAb-naive patients with HFEM or CM and unresponsiveness or contraindications for or low tolerability to >3 migraine preventive medications, who were prescribed erenumab, galcanezumab, or fremanezumab for 24 weeks.

Disclosures: This study was partially supported by the Italian Ministry of Health IRCCS San Raffaele Roma. Several authors reported receiving personal compensation, travel grants, honoraria, or research support from various sources.

Source: Barbanti P et al. Predictors of response to anti -CGRP monoclonal antibodies: A 24 -week, multicenter, prospective study on 864 migraine patients. J Headache Pain. 2022;23:138 (Nov 1). Doi: 10.1186/s10194-022-01498-6

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