Migraine evolution after the cessation of CGRP(-receptor) antibody prophylaxis: a prospective, longitudinal cohort study.

Autor: Raffaelli B; Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany., Terhart M; Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany., Overeem LH; Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany., Mecklenburg J; Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany., Neeb L; Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany., Steinicke M; Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany., Reuter U; Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany.; Universitätsmedizin Greifswald, Greifswald, Germany.
Jazyk: angličtina
Zdroj: Cephalalgia : an international journal of headache [Cephalalgia] 2022 Apr; Vol. 42 (4-5), pp. 326-334. Date of Electronic Publication: 2021 Sep 27.
DOI: 10.1177/03331024211046617
Abstrakt: Background: National and international guidelines recommend stopping migraine prophylaxis with CGRP(-receptor) monoclonal antibodies after 6-12 months of successful therapy. In this study, we aimed to analyze the course of migraine for four months after the cessation of CGRP(-receptor) antibodies use.
Methods: This longitudinal cohort study included patients with migraine who received a CGRP-(receptor) antibody for ≥8 months before treatment cessation. We analyzed headache data in the four-week period prior to mAb treatment initiation (baseline), in the month before the last mAb injection, in weeks 5-8 and 13-16 after last treatment. Primary endpoint of the study was the change of monthly migraine days from the month before last treatment to weeks 13-16. Secondary endpoints were changes in monthly headache days and monthly days with acute medication use.
Results: A total of 62 patients equally distributed between prophylaxis with the CGRP-receptor antibody erenumab and the CGRP antibodies galcanezumab or fremanezumab participated in the study. Patients reported 8.2 ± 6.6 monthly migraine days in the month before last treatment. Monthly migraine days gradually increased to 10.3 ± 6.8 in weeks 5-8 (p = 0.001) and to 12.5 ± 6.6 in weeks 13-16 (p < 0.001) after drug cessation. Monthly migraine days in weeks 13-16 were not different from baseline values (-0.8 ± 5.4; p > 0.999). Monthly headache days and monthly days with acute medication use showed a similar pattern.
Conclusions: The cessation of CGRP(-receptor) antibodies migraine prophylaxis was associated with a significant increase of migraine frequency and acute medication intake over time.
Databáze: MEDLINE
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