Monoclonal antibodies against CGRP (R): non-responders and switchers: real world data from an austrian case series.

Autor: Kaltseis K; Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria., Filippi V; Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria., Frank F; Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria., Eckhardt C; Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria., Schiefecker A; Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria., Broessner G; Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria. Gregor.broessner@i-med.ac.at.
Jazyk: angličtina
Zdroj: BMC neurology [BMC Neurol] 2023 Apr 28; Vol. 23 (1), pp. 174. Date of Electronic Publication: 2023 Apr 28.
DOI: 10.1186/s12883-023-03203-9
Abstrakt: Objective: Assessement of the responder and non-responder rate to consecutive monoclonal CGRP-antibody (CGRP-mAb) treatment, the presence of side effects, analysis of predictors of response and loss-of-effectiveness evaluation over time.
Methods: We conducted a retrospective analysis including 171 patients with episodic (EM) or chronic migraine (CM), who received one, two or three different CGRP-mAbs. Non-response was defined as ≤ 50% reduction of monthly migraine days (MMDs) in EM and ≤ 30% reduction of MMDs in CM after 3 months of treatment.
Results: 123 (71.9%) responded to the first mAb. Side effects led to treatment discontinuation in 9 (5.3%) patients. Of the 26 patients who did not respond to the first mAb or experienced a loss of efficacy over time, 11 (42.3%) responded to the second and two (28.6%) of 7 to the third monoclonal antibody. Poor response to therapy was associated with a higher monthly migraine frequency (p = 0.028), a higher number of prior preventive migraine therapies (p = 0.011) and medication overuse (p = 0.022).
Conclusion: Our findings support mAb-class switch in non-responders or in patients experiencing a loss of effectiveness. The use of a third CGRP-mAb could be beneficial for some patients.
(© 2023. The Author(s).)
Databáze: MEDLINE
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