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依瑞奈尤单抗(AMG 334)治疗发作性偏头痛:一项正在进行的开放标签研究的中期分析。

Erenumab (AMG 334) in episodic migraine: Interim analysis of an ongoing open-label study.

机构信息

From the Department of Neurology (M.A.), Danish Headache Center, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark; Department of Neurology (D.D.), Mayo Clinic, Scottsdale, AZ; NIHR-Wellcome Trust King's Clinical Research Facility (P.J.G.), Kings College London, UK; Department of Neurology (U.R.), Charité Universitätsmedizin Berlin, Germany; Jefferson Headache Center (S.S.), Thomas Jefferson University, Philadelphia, PA; Amgen Inc. (F.Z., S.C., D.D.M., R.A.L.), Thousand Oaks; and Gage Medical Writing, LLC (J.R.G.), Moorpark, CA.

出版信息

Neurology. 2017 Sep 19;89(12):1237-1243. doi: 10.1212/WNL.0000000000004391. Epub 2017 Aug 23.

Abstract

OBJECTIVE

To assess long-term safety and efficacy of anti-calcitonin gene-related peptide receptor erenumab in patients with episodic migraine (EM).

METHODS

Patients enrolled in a 12-week, double-blind, placebo-controlled clinical trial (NCT01952574) who continued in an open-label extension (OLE) study will receive erenumab 70 mg every 4 weeks for up to 5 years. This preplanned interim analysis, conducted after all participants had completed the 1-year open-label follow-up, evaluated changes in monthly migraine days (MMD), achievement of ≥50%, ≥75%, and 100% reductions, Headache Impact Test (HIT-6) score, Migraine-Specific Quality of Life (MSQ), Migraine Disability Assessment (MIDAS), and safety. Data reported as observed without imputation for missing data.

RESULTS

Of 472 patients enrolled in the parent study, 383 continued in the OLE with a median exposure to erenumab of 575 days (range 28-822 days). Mean (SD) MMD were 8.8 (2.6) at parent study baseline, 6.3 (4.2) at week 12 (beginning of OLE), and 3.7 (4.0) at week 64 (mean change from baseline [reduction] of 5.0 days). At week 64, 65%, 42%, and 26% achieved ≥50%, ≥75%, and 100% reduction in MMD, respectively. Mean HIT-6 scores were 60.2 (6.3) at baseline and 51.7 (9.2) at week 64. MSQ and MIDAS improvements from baseline were maintained through week 64. Safety profiles during the OLE were similar to those in the double-blind phase, which overall were similar to placebo.

CONCLUSIONS

One-year efficacy, supported by functional improvements and favorable safety and tolerability profiles, supports further investigation of erenumab as a preventive treatment in patients with EM.

CLINICALTRIALSGOV IDENTIFIER

NCT01952574.

CLASSIFICATION OF EVIDENCE

This study provides Class IV evidence that for patients with episodic migraine, erenumab reduces long-term MMD and improves headache-related disability and migraine-specific quality of life.

摘要

目的

评估降钙素基因相关肽受体拮抗剂依那西普在偶发性偏头痛(EM)患者中的长期安全性和疗效。

方法

在一项为期 12 周的双盲、安慰剂对照临床试验(NCT01952574)中入组的患者继续进行开放标签扩展(OLE)研究,将接受依那西普 70mg 每 4 周一次,最长 5 年。这是一项预先计划的中期分析,在所有参与者完成 1 年的开放标签随访后进行,评估每月偏头痛天数(MMD)的变化、≥50%、≥75%和 100%的减少、头痛影响测试(HIT-6)评分、偏头痛特异性生活质量(MSQ)、偏头痛残疾评估(MIDAS)和安全性。数据未经插补缺失数据进行观察报告。

结果

在入组的 472 例患者中,有 383 例继续进入 OLE,依那西普的中位暴露时间为 575 天(范围 28-822 天)。基线时平均(SD)每月偏头痛天数(MMD)为 8.8(2.6),第 12 周(OLE 开始时)为 6.3(4.2),第 64 周为 3.7(4.0),与基线相比平均减少(减少)5.0 天。第 64 周时,分别有 65%、42%和 26%的患者达到 MMD 的≥50%、≥75%和 100%的减少。基线时 HIT-6 评分平均为 60.2(6.3),第 64 周为 51.7(9.2)。从基线开始,MSQ 和 MIDAS 的改善一直持续到第 64 周。OLE 期间的安全性特征与双盲期相似,总体与安慰剂相似。

结论

为期 1 年的疗效,加上功能改善和良好的安全性和耐受性特征,支持进一步研究依那西普作为 EM 患者的预防性治疗。

临床试验.gov 标识符:NCT01952574。

证据分类

本研究提供了 IV 级证据,表明对于偶发性偏头痛患者,依那西普可减少长期偏头痛天数,并改善头痛相关残疾和偏头痛特异性生活质量。

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