COVID-19 大流行期间偏头痛患者使用抗 CGRP 单克隆抗体的安全性：当前和未来的影响。
Safety of anti-CGRP monoclonal antibodies in patients with migraine during the COVID-19 pandemic: Present and future implications.
机构信息
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.
出版信息
Neurologia (Engl Ed). 2021 Oct;36(8):611-617. doi: 10.1016/j.nrleng.2021.03.005.
BACKGROUND AND OBJECTIVE
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.
METHODS
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.
RESULTS
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.
CONCLUSION
Anti-CGRP mAbs may be safe in clinical practice, presenting no association with increased risk of COVID-19.
背景与目的
降钙素基因相关肽（CGRP）是一种参与偏头痛病理生理学的神经肽，也已知在呼吸系统以及免疫性疾病如脓毒症中发挥作用。我们分析了在由 SARS-CoV-2 冠状病毒引起的 COVID-19 大流行期间，偏头痛患者使用 CGRP 拮抗剂的影响。
方法
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分发的全国性调查，我们收集了正在接受抗 CGRP 单克隆抗体（mAb）治疗的偏头痛患者出现 COVID-19 症状（包括头痛）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了比较。我们还对出现 COVID-19 症状的患者进行了亚分析。
结果
我们招募了 300 名偏头痛患者：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 名患者（13.7%）符合 COVID-19 的诊断标准，抗 CGRP mAb 治疗与无抗 CGRP mAb 治疗的患者之间无统计学差异（分别为 16.1%和 11.0%；P=.320）。COVID-19 患者中，48.8%（20/41）就诊于急诊室，12.2%（5/41）住院。同样，在接受和不接受抗 CGRP mAb 治疗的患者之间未发现临床差异。
结论
抗 CGRP mAb 在临床实践中可能是安全的，与 COVID-19 风险增加无关。
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