Caronna E, José Gallardo V, Alpuente A, Torres-Ferrus M, Sánchez-Mateo N M, Viguera-Romero J, López-Veloso A C, López-Bravo A, Gago-Veiga A B, Irimia Sieira P, Porta-Etessam J, Santos-Lasaosa S, Pozo-Rosich P
Headache Unit, Neurology Department, Hospital Universitari Vall d'Hebron, Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; Headache and Neurological Pain Research Group, Vall d'Hebron Research Institute, Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
Headache and Neurological Pain Research Group, Vall d'Hebron Research Institute, Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
Neurologia (Engl Ed). 2021 Mar 19;36(8):611-7. doi: 10.1016/j.nrl.2021.03.003.
CGRP, a neuropeptide involved in migraine pathophysiology, is also known to play a role in the respiratory system and in immunological conditions such as sepsis. We analyzed the impact of the use of CGRP antagonists in patients with migraine during the COVID-19 pandemic, caused by the SARS-CoV-2 coronavirus.
This is a multicentre cross-sectional study. From May to November 2020, through a national survey distributed by the Spanish Society of Neurology, we collected data about the presence of COVID-19 symptoms including headache and their characteristics and severity in patients with migraine treated with anti-CGRP monoclonal antibodies (mAb), and compared them with patients with migraine not receiving this treatment. We also conducted a subanalysis of patients with COVID-19 symptoms.
We recruited 300 patients with migraine: 51.7% (155/300) were taking anti-CGRP mAbs; 87.3% were women (262/300). Mean age (standard deviation) was 47.1 years (11.6). Forty-one patients (13.7%) met diagnostic criteria for COVID-19, with no statistically significant difference between patients with and without anti-CGRP mAb treatment (16.1% vs 11.0%, respectively; P=.320). Of the patients with COVID-19, 48.8% (20/41) visited the emergency department and 12.2% (5/41) were hospitalised. Likewise, no clinical differences were found between the groups of patients with and without anti-CGRP mAb treatment.
Anti-CGRP mAbs may be safe in clinical practice, presenting no association with increased risk of COVID-19.
降钙素基因相关肽（CGRP）是一种参与偏头痛病理生理过程的神经肽，已知其在呼吸系统以及脓毒症等免疫性疾病中也发挥作用。我们分析了在严重急性呼吸综合征冠状病毒2（SARS-CoV-2）引发的2019冠状病毒病（COVID-19）大流行期间，使用CGRP拮抗剂对偏头痛患者的影响。
这是一项多中心横断面研究。2020年5月至11月，通过西班牙神经病学学会开展的一项全国性调查，我们收集了接受抗CGRP单克隆抗体（mAb）治疗的偏头痛患者中COVID-19症状（包括头痛）的存在情况及其特征和严重程度的数据，并将其与未接受该治疗的偏头痛患者进行比较。我们还对有COVID-19症状的患者进行了亚分析。
我们招募了300例偏头痛患者：51.7%（155/300）正在服用抗CGRP mAb；87.3%为女性（262/300）。平均年龄（标准差）为47.1岁（11.6）。41例患者（13.7%）符合COVID-19诊断标准，接受和未接受抗CGRP mAb治疗的患者之间无统计学显著差异（分别为16.1%和11.0%；P = 0.320）。在患有COVID-19的患者中，48.8%（20/41）前往急诊科就诊，12.2%（5/41）住院治疗。同样，接受和未接受抗CGRP mAb治疗的患者组之间未发现临床差异。
抗CGRP mAb在临床实践中可能是安全的，与COVID-19风险增加无关。
