Neuroscience Section, Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, 67100, L'Aquila, Italy.
J Headache Pain. 2019 May 6;20(1):49. doi: 10.1186/s10194-019-1000-5.
Migraine is a major public health issue associated with significant morbidity, considerable negative impact on quality of life, and significant socioeconomic burden. Preventive treatments are required to reduce the occurrence and the severity of acute attacks and to minimize the use of abortive medications and the associate risk of drug-related adverse events, as well as the onset of medication-overuse headache and chronification of migraine. We performed a review of all available evidence on the safety and efficacy of monoclonal antibodies targeting the calcitonin gene-related peptide or its receptor for the preventive treatment of migraine to provide evidence-based guidance on their use in clinical practice. Monoclonal antibodies targeting the calcitonin gene-related peptide or its receptor are mechanism-specific drugs for the preventive treatment of migraine. Double-blind randomized clinical trials have shown that monoclonal antibodies targeting the calcitonin gene-related peptide or its receptor are effective across all the spectrum of migraine patients who require prevention and have a good safety and tolerability profile. Nevertheless, high costs limit the affordability of those drugs at the moment.
Specificity, long half-life, efficacy, tolerability, and ease of use make monoclonal antibodies targeting the calcitonin gene-related peptide or its receptor an appealing treatment option for migraine prevention. Optimal strategies to manage treatment over time still need to be clarified with real-life data.
偏头痛是一个主要的公共卫生问题，与较高的发病率、对生活质量的严重负面影响以及显著的社会经济负担相关。需要预防性治疗来减少急性发作的发生和严重程度，尽量减少使用止吐药物和相关药物不良反应的风险，以及避免药物滥用性头痛和偏头痛的慢性化。我们对所有关于靶向降钙素基因相关肽或其受体的单克隆抗体预防偏头痛的安全性和有效性的现有证据进行了综述，为其在临床实践中的应用提供了基于证据的指导。靶向降钙素基因相关肽或其受体的单克隆抗体是预防偏头痛的机制特异性药物。双盲随机临床试验表明，靶向降钙素基因相关肽或其受体的单克隆抗体对所有需要预防的偏头痛患者均有效，且具有良好的安全性和耐受性。然而，高成本限制了这些药物的可负担性。
特异性、长半衰期、疗效、耐受性和易用性使靶向降钙素基因相关肽或其受体的单克隆抗体成为预防偏头痛的一种有吸引力的治疗选择。仍需要使用真实数据来明确管理治疗时间的最佳策略。
