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依洛尤单抗治疗偏头痛的预防性治疗:无头痛天数的功能状态。

Fremanezumab for preventive treatment of migraine: Functional status on headache-free days.

机构信息

From the Mayo Clinic (J.V., D.W.D.), Phoenix, AZ; Montefiore Headache Center (R.B.L.), Albert Einstein College of Medicine, New York, NY; Teva Pharmaceuticals Ltd (Y.M., P.S.L.), Netanya, Israel; and Teva Pharmaceuticals Ltd (M.E.B.), Frazer, PA. Dr. Bigal is now at Purdue Pharma, Stamford, CT.

出版信息

Neurology. 2018 Sep 18;91(12):e1152-e1165. doi: 10.1212/01.wnl.0000544321.19316.40. Epub 2018 Aug 17.

Abstract

OBJECTIVE

To evaluate the effect of fremanezumab on the functional status on headache-free days in phase 2 episodic migraine (EM) and chronic migraine (CM) studies.

METHODS

Functional status data were collected prospectively via the electronic headache diary on all headache-free days by patients answering questions regarding work/school/household chore performance, speed of work completion, concentration, and feeling of fatigue. Individuals with EM receiving monthly doses of fremanezumab 225 mg (n = 96) or 675 mg (n = 97) or placebo (n = 104) were compared. Individuals with CM receiving fremanezumab 675 mg followed by monthly 225 mg (n = 88) and 900 mg (n = 86) were also independently compared to those receiving placebo (n = 89).

RESULTS

In patients with EM, compared to patients receiving placebo, those receiving fremanezumab experienced an increased number of headache-free days with normal function in work/school/household chore performance and concentration/mental fatigue measures compared to their baseline over the entire treatment period (all < 0.005). An increased number of headache-free days with normal functional performance for some measures was also found in the CM group in those treated with fremanezumab.

CONCLUSION

There was an increased number of headache-free days with normal functional performance on all measures for the patients with EM and some measures for patients with CM in the fremanezumab-treated groups. Further research is required to confirm these findings in a prospective study and to clarify the underlying mechanism(s).

CLINICALTRIALSGOV IDENTIFIER

NCT02025556 and NCT02021773.

CLASSIFICATION OF EVIDENCE

This study provides Class II evidence that for patients with migraine, fremanezumab increases normal functional performance on headache-free days.

摘要

目的

评估在 2 期发作性偏头痛(EM)和慢性偏头痛(CM)研究中,依洛尤单抗对无头痛日功能状态的影响。

方法

通过电子头痛日记前瞻性收集所有无头痛日的功能状态数据,患者回答关于工作/学校/家务表现、工作完成速度、注意力和疲劳感的问题。每月接受依洛尤单抗 225mg(n=96)或 675mg(n=97)或安慰剂(n=104)治疗的 EM 患者,每月接受依洛尤单抗 675mg 随后每月接受 225mg(n=88)和 900mg(n=86)治疗的 CM 患者,分别与接受安慰剂的患者(n=89)进行比较。

结果

与接受安慰剂的患者相比,在 EM 患者中,与基线相比,在整个治疗期间,接受依洛尤单抗治疗的患者在工作/学校/家务表现和注意力/精神疲劳测量方面,无头痛日且功能正常的天数增加(均<0.005)。在接受依洛尤单抗治疗的 CM 患者中,某些测量指标的无头痛日且功能正常的天数也有所增加。

结论

在 EM 患者中,依洛尤单抗治疗组的所有测量指标和 CM 患者的一些测量指标的无头痛日且功能正常的天数均有所增加。需要进一步的研究在前瞻性研究中确认这些发现,并阐明潜在的机制。

临床试验注册号

NCT02025556 和 NCT02021773。

证据分类

本研究提供了 II 级证据,表明对于偏头痛患者,依洛尤单抗可提高无头痛日的正常功能表现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c156/6161555/172b577aebe1/NEUROLOGY2017844647FF1.jpg

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