Headache Unit, Neurology Department, Vall d'Hebron University Hospital, Barcelona, Spain.
Headache and Neurological Pain Research Group, Department de Medicine, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain.
Adv Ther. 2021 Jun;38(6):3154-3165. doi: 10.1007/s12325-021-01708-8. Epub 2021 May 5.
The consistency of the treatment effect of galcanezumab throughout the dosing interval is examined in patients with episodic and chronic migraine.
This study was a post hoc analysis of clinical trial data from episodic (EVOLVE-1; EVOLVE-2; both 6-month duration) and chronic (REGAIN; 3-month duration) migraine double-blind trials evaluating the efficacy of a once-monthly injection of galcanezumab 120 mg relative to placebo. Adults with episodic (placebo, n = 894; galcanezumab, n = 444) or chronic migraine (placebo, n = 558; galcanezumab, n = 278) were included. Mean change from baseline in weekly migraine headache days, averaged across all months for each week of the dosing interval, was compared between groups and within the galcanezumab group during weeks 1 and 4. Additional analyses examined the mean difference from placebo in weekly migraine headache days and a day-by-day analysis.
Weekly migraine headache day reduction was significantly greater with galcanezumab relative to placebo every week (P < 0.001) and did not differ during weeks 1 and 4 for those with episodic (P = 0.740) or chronic migraine (P = 0.231) taking galcanezumab. Estimated probabilities of migraine on day 2 and day 30 did not differ for those with episodic (P = 0.61) or chronic migraine (P = 0.616) taking galcanezumab.
This analysis demonstrates once monthly galcanezumab exhibits consistent efficacy throughout the dosing interval among the population of patients with migraine in three clinical trials evaluating the efficacy of galcanezumab. There is no evidence from these trials that the effect of galcanezumab "wears off" at the end of the dosing interval.
ClinicalTrials.gov identifier: EVOLVE-1 (NCT02614183); EVOLVE-2 (NCT02614196); REGAIN (NCT02614261).
本研究旨在考察加奈珠单抗在发作性和慢性偏头痛患者中的治疗效果在整个给药间隔内的一致性。
本研究是对发作性偏头痛(EVOLVE-1;EVOLVE-2;均为 6 个月疗程)和慢性偏头痛(REGAIN;3 个月疗程)双盲临床试验的临床数据进行的事后分析,旨在评估每月一次注射 120mg 加奈珠单抗相对于安慰剂的疗效。纳入了发作性偏头痛(安慰剂,n=894;加奈珠单抗,n=444)或慢性偏头痛(安慰剂,n=558;加奈珠单抗,n=278)的成年患者。比较了各组之间以及加奈珠单抗组在给药间隔的每周 1 至 4 周内,从基线每周偏头痛头痛天数的平均变化。还进行了每周偏头痛头痛天数与安慰剂的平均差值分析以及逐日常规分析。
与安慰剂相比,加奈珠单抗每周偏头痛头痛天数减少的幅度均显著更大(P<0.001),且对于发作性偏头痛(P=0.740)或慢性偏头痛(P=0.231)患者,在给药间隔的第 1 至 4 周内,使用加奈珠单抗的患者之间没有差异。对于使用加奈珠单抗的发作性偏头痛(P=0.61)或慢性偏头痛(P=0.616)患者,在第 2 天和第 30 天偏头痛的估计概率没有差异。
本分析表明,在三项评估加奈珠单抗疗效的临床试验中,偏头痛患者群体中,每月一次的加奈珠单抗在整个给药间隔内均具有一致的疗效。这些试验没有证据表明加奈珠单抗的疗效在给药间隔结束时“减弱”。
ClinicalTrials.gov 标识符:EVOLVE-1(NCT02614183);EVOLVE-2(NCT02614196);REGAIN(NCT02614261)。