Clinical Edge Journal Scan

Switch from anti-CGRP receptor to anti-CGRP ligand mAb offers promise in treatment-refractory chronic migraine


 

Key clinical point: Nearly one third of patients with treatment-refractory chronic migraine (CM) who did not respond to anti-calcitonin gene-related peptide (CGRP) receptor monoclonal antibodies (mAb) showed a meaningful response to anti-CGRP ligand mAb.

Major finding: Overall, 25.6% of patients achieved ≥30% reduction in monthly migraine days (MMD) after 3 months of initiating fremanezumab and were considered responders, with the mean MMD significantly reducing from 21.4 days at baseline to 15.0 days at 3 months ( P = .007), 8.6 days at 6 months ( P = .007), and 8.6 days at the last follow-up ( P = .001). Treatment-related side effects were generally mild.

Study details: This long-term prospective real-world analysis included 39 patients with treatment-refractory CM who did not achieve a meaningful response to erenumab and switched to fremanezumab.

Disclosures: This study did not disclose the funding source. Some authors declared receiving research grants, funding for travel, personal fees as speakers or advisors, or honoraria for participation in advisory boards from various sources.

Source: Lambru G et al. Long-term effect of switching from an anti-CGRP receptor to an anti-CGRP ligand antibody in treatment-refractory chronic migraine: A prospective real-world analysis. Neurotherapeutics. 2023 (Jul 10). Doi: 10.1007/s13311-023-01394-0

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