Clinical Edge Journal Scan

CGRP mAb Outperform OnabotulinumtoxinA in Difficult-to-Treat Chronic Migraine


 

Key clinical point: Calcitonin gene-related peptide (CGRP) monoclonal antibodies (mAb) were more effective than onabotulinumtoxinA in patients with chronic migraine (CM), even in those who were difficult-to-treat (DTT) and did not respond to ≥3 preventive treatments.

Major finding: At 6 months, CGRP mAb vs onabotulinumtoxinA significantly reduced monthly migraine days (−13.0 vs −8.7 days/month; P < .001) in overall populations, with a similar reduction observed in those who were DTT (−13.0 vs −9.1 days/month; P < .001). Both treatments were well tolerated, with no treatment discontinuation being observed because of adverse events.

Study details: This multicenter, real-world study included 316 and 333 patients with CM who received ≥1 dose of CGRP mAb and onabotulinumtoxinA, respectively, and of whom 544 were DTT and had failed to respond ≥3 preventive treatments.

Disclosures: This study was funded by Taiwan National Science and Technology Council and others. Three authors declared receiving research grants, personal fees as advisors or speakers, or honoraria as speakers from various sources.

Source: Wang Y-F, Yang F-C, Chen L-A, et al. Comparative effectiveness and tolerability of calcitonin gene-related peptide (CGRP) monoclonal antibodies and onabotulinumtoxinA in chronic migraine: A multicenter, real-world study in Taiwan. Eur J Neurol. 2024 :e16372 (Jun 5). doi: 10.1111/ene.16372 Source

Recommended Reading

Interictal Burden, Disability, Allodynia Linked to Increased Likelihood of Seeking Migraine Care
Migraine ICYMI
Measuring Cognition in Migraine, One Patient at a Time
Migraine ICYMI
Prior Non-response to Anti-CGRP mAb Curbs Efficacy of Eptinezumab
Migraine ICYMI
Healthy Lifestyle and Good Cardiovascular Health Can Ward Off Migraine
Migraine ICYMI
Rimegepant Reduces Need for Analgesics and Antiemetics in Adults With Migraine
Migraine ICYMI
Atogepant Shows Sustained Efficacy in Episodic Migraine
Migraine ICYMI
Predictors for Anti-CGRP mAb Response in Migraine
Migraine ICYMI
Migraine Not Linked to Atrial Fibrillation Risk
Migraine ICYMI
Meta-Analysis Shows Erenumab Is an Excellent Treatment Option in Migraine
Migraine ICYMI
Switching Between Anti-CGRP mAb Worsens Disease Burden in Migraine
Migraine ICYMI