Headache and Neurosonology Unit, Neurology, Campus Bio-Medico University Hospital, Rome, Italy.
Neurological Clinic, Marche Polytechnic University, Ancona, Italy.
Cephalalgia. 2021 Jan;41(1):90-98. doi: 10.1177/0333102420956692. Epub 2020 Aug 31.
To assess whether erenumab influences cerebral vasomotor reactivity and flow-mediated dilation in migraine patients.
Consecutive migraineurs prescribed erenumab at our Headache Centre and age and sex-matching controls were invited to participate in this observational longitudinal study. Patients were evaluated for cerebral vasomotor reactivity to hypercapnia (breath-holding index) in middle and posterior cerebral arteries and for brachial corrected flow mediated dilation at baseline (T0), after 2 weeks from the first erenumab injection (T2) and after 2 weeks from the fourth Erenumab injection (T18). Patients displaying a reduction of at least 50% in monthly migraine days after completing the fourth month of therapy were classified as responders.
Sixty patients and 25 controls agreed to participate. Middle and posterior cerebral artery mean flow velocities, breath-holding index and flow-mediated dilation did not differ at T0 and from T0 to T2 in patients and controls. In patients, we neither observed a variation of the explored variables from T0 to T18 nor an interaction between evaluation times (T0-T2 or T0-T18) and chronic condition at T0, responder state or erenumab fourth dose.
Our findings demonstrate that erenumab preserves cerebral vasomotor reactivity and flow-mediated dilation in migraineurs without aura.
评估依瑞奈尤单抗是否会影响偏头痛患者的脑血管反应性和血流介导的扩张。
连续入组在我们头痛中心接受依瑞奈尤单抗治疗的偏头痛患者和年龄及性别匹配的对照组，邀请他们参与这项观察性纵向研究。患者接受了关于中脑和后脑血管对高碳酸血症的脑血管反应性（屏气指数）和基线（T0）、第一次依瑞奈尤单抗注射后 2 周（T2）和第四次依瑞奈尤单抗注射后 2 周（T18）的肱动脉校正血流介导扩张的评估。在完成第四个月的治疗后每月偏头痛天数减少至少 50%的患者被归类为应答者。
60 名患者和 25 名对照者同意参与。在患者和对照组中，中脑和后动脉平均血流速度、屏气指数和血流介导扩张在 T0 时以及 T0 至 T2 时均无差异。在患者中，我们既没有观察到从 T0 到 T18 时探索变量的变化，也没有观察到 T0 时的慢性疾病、应答状态或依瑞奈尤单抗第四次剂量与评估时间（T0-T2 或 T0-T18）之间的相互作用。
我们的研究结果表明，依瑞奈尤单抗可维持无先兆偏头痛患者的脑血管反应性和血流介导的扩张。
