Neuroscience Section, Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, Via Vetoio 1, 67100, L'Aquila, Italy.
Department of Neurology, 'G. Mazzini' Hospital, Teramo, Italy.
J Headache Pain. 2021 Jan 6;22(1):1. doi: 10.1186/s10194-020-01213-3.
Triptans and erenumab are both migraine-specific agents acting on the calcitonin gene-related peptide pathway. Therefore, response to triptans might be associated with response to erenumab.
In our study, consecutive patients referring to the Headache Centers of the Abruzzo region from January 2019 to March 2020 and treated with erenumab were interviewed about past use and efficacy of triptans. Triptan users were classified as 'triptan responders' if they were headache-free 2 h after treating ≥3 migraine attacks with ≥1 triptan. We considered patients as 'erenumab responders', if they had a ≥ 50% mean reduction in monthly migraine days between the 4th and the 6th month from treatment start compared with baseline. Of 91 triptan users, 73 (80.2%) were triptan responders and 58 (63.7%) were erenumab responders. The odds ratio of being erenumab responder was 3.64 (95% CI, 1.25-10.64) for triptan users as compared to non-users. (P = 0.014). Besides, starting erenumab improved triptan response in both erenumab responders and non-responders.
Our data of an association between response to triptans and response to erenumab can be useful for patient advice and to improve the understanding of migraine pathophysiology and treatment.
曲普坦类和依那西普都是作用于降钙素基因相关肽途径的偏头痛特异性药物。因此,对曲普坦类的反应可能与对依那西普的反应相关。
在我们的研究中,连续的患者在 2019 年 1 月至 2020 年 3 月期间从阿布鲁佐地区的头痛中心就诊,并接受了依那西普治疗,他们接受了关于过去使用和曲普坦类药物疗效的采访。如果患者在≥3 次偏头痛发作中,每次使用≥1 种曲普坦后 2 小时头痛消失,则将其归类为“曲普坦类反应者”。如果患者在治疗开始后的第 4 至 6 个月与基线相比,每月偏头痛天数减少≥50%,则认为患者为“依那西普反应者”。在 91 名曲普坦使用者中,73 名(80.2%)为曲普坦类反应者,58 名(63.7%)为依那西普反应者。与非使用者相比,曲普坦使用者成为依那西普反应者的几率比为 3.64(95%可信区间,1.25-10.64)(P=0.014)。此外,依那西普的起始治疗改善了依那西普反应者和非反应者的曲普坦类反应。
我们关于曲普坦类反应与依那西普反应之间关联的数据可用于患者咨询,并有助于提高对偏头痛病理生理学和治疗的理解。