难治性慢性偏头痛伴药物过度使用性头痛的依瑞奈umab 真实生活评估。

Real-life assessment of erenumab in refractory chronic migraine with medication overuse headache.

机构信息

Department of Biomedical and NeuroMotor Sciences of Bologna, University of Bologna, Bologna, Italy.

Medical Toxicology-Headache and Drug Abuse Research Centre, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.

出版信息

Neurol Sci. 2022 Feb;43(2):1273-1280. doi: 10.1007/s10072-021-05426-5. Epub 2021 Jul 5.

DOI:10.1007/s10072-021-05426-5

PMID:34224026

Abstract

OBJECTIVE

To determine whether erenumab is effective and safe in refractory chronic migraine with medication overuse headache.

METHODS

In this prospective, multicentric, real-life study, chronic migraine with medication overuse headache patients who received erenumab were recruited. Study inclusion was limited to patients who previously failed onabotulinumtoxinA in addition to at least three other pharmacological commonly used migraine preventive medication classes.

RESULTS

Of 396 patients who received erenumab, 38% (n = 149) met inclusion criteria. After 3 months, 51% (n = 76) and 20% (n = 30) patients achieved ≥ 50% and ≥ 75% reduction in monthly headache days, respectively. Monthly pain medications intake decreased from 46.1 ± 35.3 to 16.8 ± 13.9 (p < 0.001), while monthly headache days decreased from 25.4 ± 5.4 to 14.1 ± 8.6 (p < 0.001). Increasing efficacy of erenumab over the study period was observed. Allodynia was a negative predictive factor of erenumab response (odds ratio = 0.47; p = 0.03). Clinical conversion to episodic migraine with no medication overuse was observed in 64% (n = 96) patients. No serious adverse events were observed.

CONCLUSIONS

Erenumab reduced significantly migraine frequency and pain medication intake in refractory chronic migraine with MOH patients.

摘要

目的

评估依瑞奈尤单抗治疗药物过度使用性头痛的难治性慢性偏头痛的有效性和安全性。

方法

本前瞻性、多中心、真实世界研究纳入了接受依瑞奈尤单抗治疗的药物过度使用性头痛的慢性偏头痛患者。研究纳入标准为先前接受过肉毒毒素 A 治疗且至少三种其他常用偏头痛预防性药物治疗失败的患者。

结果

在 396 例接受依瑞奈尤单抗治疗的患者中，38%（n=149）符合纳入标准。治疗 3 个月后，51%（n=76）和 20%（n=30）的患者每月头痛天数分别减少≥50%和≥75%。每月止痛药摄入量从 46.1±35.3 降至 16.8±13.9（p<0.001），每月头痛天数从 25.4±5.4 降至 14.1±8.6（p<0.001）。研究期间观察到依瑞奈尤单抗的疗效逐渐增加。感觉异常是依瑞奈尤单抗反应的负预测因素（比值比=0.47；p=0.03）。64%（n=96）的患者转为无药物过度使用的发作性偏头痛。未观察到严重不良事件。