Pooled Analysis of Real-World Evidence Supports Anti-CGRP mAbs and OnabotulinumtoxinA Combined Trial in Chronic Migraine
| Autor: | Damiana Scuteri, Paolo Tonin, Pierluigi Nicotera, Marilù Vulnera, Giuseppina Cristina Altieri, Assunta Tarsitano, Giacinto Bagetta, Maria Tiziana Corasaniti |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: |
antagonists & inhibitors [Calcitonin Gene-Related Peptide]
prevention & control [Migraine Disorders] Migraine Disorders Calcitonin Gene-Related Peptide Health Toxicology and Mutagenesis anti-CGRP monoclonal antibodies Antibodies Monoclonal Toxicology PRISMA 2020 onabotulinumtoxinA migraine pooled analysis Treatment Outcome Humans Drug Therapy Combination ddc:610 adverse effects [Drug Therapy Combination] Botulinum Toxins Type A therapeutic use [Antibodies Monoclonal] therapeutic use [Botulinum Toxins Type A] |
| Zdroj: | Toxins; Volume 14; Issue 8; Pages: 529 Toxins 14(8), 529 (2022). doi:10.3390/toxins14080529 special issue: "Botulinum Neurotoxin: Shared/Common Mechanisms in the Treatment of Pain, Spasticity and Movement Disorders" |
| ISSN: | 2072-6651 |
| DOI: | 10.3390/toxins14080529 |
| Popis: | OnabotulinumtoxinA, targeting the CGRP machinery, has been approved for the last two decades for chronic migraine prevention. The recently approved monoclonal antibodies (mAbs) directed towards the calcitonin gene-related peptide (CGRP) pathway open a new age for chronic migraine control. However, some 40% patients suffering from chronic migraine is still resistant to treatment. The aim of this work is to answer the following PICOS (participants intervention comparator outcome study design) question: Is there evidence of efficacy and safety of the combined administration of anti-CGRP mAbs and onabotulinumtoxinA in chronic migraine? A systematic review and meta-analysis [Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 recommendations] was made up to 19 April 2022. The results are encouraging: the combined treatment proved to afford ≥50% monthly headache days (MHDs)/frequency reduction respect to baseline in up to 58.8% of patients; in comparison, anti-CGRP mAbs reduce MHDs of 1.94 days from baseline and botulinum toxin of 1.86 days. Our study demonstrates for the first time that the combination therapy of onabotulinumtoxinA with anti-CGRP mAbs affords a reduction of 2.67 MHDs with respect to onabotulinumtoxinA alone, with moderate certainty of evidence. Adequately powered, good-quality studies are needed to confirm the response to combination therapy in terms of efficacy and safety. PROSPERO registration: CRD42022313640. |
| Databáze: | OpenAIRE |
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