Evaluating the efficacy of CGRP mAbs and gepants for the preventive treatment of migraine: A systematic review and network meta-analysis of phase 3 randomised controlled trials
| Autor: | Faraidoon Haghdoost, Francesca Puledda, David Garcia-Azorin, Eva-Maria Huessler, Roberta Messina, Patricia Pozo-Rosich |
|---|---|
| Přispěvatelé: | Institut Català de la Salut, [Haghdoost F] The George Institute for Global Health, University of New South Wales, Sydney, Australia. [Puledda F] Headache Group, Wolfson CARD, SLaM Biomedical Research Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, National Institute for Health Research-Wellcome Trust King’s Clinical Research Facility, King’s College Hospital, London, United Kingdom. [Garcia-Azorin D] Headache Unit, Department of Neurology, Hospital Clínico Universitario de Valladolid, Gerencia Regional de Salud de Castilla y Leon, Valladolid, Spain. [Huessler EM] Institute for Medical Informatics, Biometry and Epidemiology, University Hospital Essen, Germany. [Messina R] Neuroimaging Research Unit and Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy. [Pozo-Rosich P] Unitat de Cefalees, Servei de Neurologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Grup de Recerca de Cefalea i Dolor Neurològic, Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain, Vall d'Hebron Barcelona Hospital Campus |
| Rok vydání: | 2023 |
| Předmět: |
enfermedades del sistema nervioso::enfermedades del sistema nervioso central::enfermedades cerebrales::trastornos con cefaleas::cefaleas primarias::trastornos migrañosos [ENFERMEDADES]
Otros calificadores::/uso terapéutico [Otros calificadores] Medizin Otros calificadores::Otros calificadores::/farmacoterapia [Otros calificadores] Migranya - Tractament General Medicine Other subheadings::Other subheadings::/drug therapy [Other subheadings] Neuropèptids aminoácidos péptidos y proteínas::péptidos::neuropéptidos::péptido relacionado con el gen de calcitonina [COMPUESTOS QUÍMICOS Y DROGAS] Other subheadings::/therapeutic use [Other subheadings] Neurology (clinical) Calcitonina Nervous System Diseases::Central Nervous System Diseases::Brain Diseases::Headache Disorders::Headache Disorders Primary::Migraine Disorders [DISEASES] Amino Acids Peptides and Proteins::Peptides::Neuropeptides::Calcitonin Gene-Related Peptide [CHEMICALS AND DRUGS] |
| Zdroj: | Scientia |
| ISSN: | 1468-2982 0333-1024 |
| Popis: | Background Several novel treatments targeting the calcitonin gene-related peptide pathway have been developed for migraine. We evaluated the efficacy of these medications, including atogepant, rimegepant, erenumab, eptinezumab, fremanezumab, and galcanezumab, for the prevention of migraine via network meta-analysis. Methods Databases, including MEDLINE via PubMed, EMBASE, and Cochrane central, were systematically reviewed, and all eligible phase 3 randomised controlled trials were included. Results Nineteen studies (n = 14,584 participants) were included. Studies included episodic (n = 11) and chronic (n = 4) migraine or both (n = 4). All interventions, except for eptinzumab 30 mg, significantly reduced mean monthly migraine days compared to placebo. All medications had a higher ≥50% responder rate than placebo and results were statistically significant in those with the subcutaneous or intravenous route of administrations, but not with the oral one. All medications significantly reduced mean monthly headache days, although no data for this outcome was available for rimegepant, and mean monthly acute medication days, with no data for eptinezumab. Conclusion The results show that medications targeting calcitonin gene-related peptide were effective in preventing migraine compared to placebo. Considering limitations of single studies, different populations such as episodic and chronic migraine, and the absence of head-to-head trials, all novel treatments decreased mean monthly migraine and headache days, and showed higher 50%, 75% and 100% responder rates than placebo. Trial registration: PROSPERO registration: CRD42022310579 |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|