Gottschalk Christopher, Buse Dawn C, Marmura Michael J, Torphy Bradley, Pavlovic Jelena M, Dumas Paula K, Lalvani Nim, Blumenfeld Andrew
Division of General Neurology, Neurology, Yale School of Medicine, Yale Physicians Building, 800 Howard Avenue, Ste Lower Level, New Haven, CT 06519, USA.
Montefiore Headache Center, Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA.
Ther Adv Neurol Disord. 2022 May 31;15:17562864221095902. doi: 10.1177/17562864221095902. eCollection 2022.
Recently approved migraine preventive therapies facilitate rapid control of migraine activity, potentially improving patients' lives and minimizing the societal burden of migraine. This review synthesizes available evidence on rates and timing of early onset of migraine prevention and identifies patient-level outcomes related to early onset prevention. This evidence-based scoping review identified all available clinical trial evidence regarding the early onset of prevention of migraine, under the hypothesis '. Early onset of prevention was defined as migraine preventive benefits within 30 days post-administration. PubMed, EMBASE, and CINAHL were searched for publications between 1988 and 2020. Overall, 16 publications described 18 studies. All studies were conducted in approved treatments [four anti-calcitonin gene-related peptide (CGRP) monoclonal antibodies and one chemodenervation agent] in patients with episodic/chronic migraine; no publications were identified for traditional oral agents for early migraine prevention. Compared to placebo, erenumab (three studies) reduced weekly migraine days within 1 week; fremanezumab (six studies) increased reports of no headache of at least moderate severity on Day 1 and significantly reduced migraine frequency within 1 week; galcanezumab (three studies) significantly reduced the mean number of patients with migraine beginning Day 1 and each day of the first week; eptinezumab (four studies) significantly reduced migraine attack likelihood on Day 1 by > 50% baseline; and onabotulinumtoxinA (two studies) reduced headache and migraine days within 1 week. Four publications described function, disability, and quality of life improvements as early as Week 4; none reported cost-benefit. Anti-CGRP monoclonal antibodies (erenumab, fremanezumab, galcanezumab, and eptinezumab) and a chemodenervation agent (onabotulinumtoxinA) provide clinically relevant benefits during the first treatment week. Literature describing clinically relevant benefits regarding early onset of prevention in patients with migraine is limited.
最近获批的偏头痛预防性疗法有助于快速控制偏头痛发作，有可能改善患者生活并将偏头痛的社会负担降至最低。本综述综合了关于偏头痛预防早期发作的发生率和时间的现有证据，并确定了与早期发作预防相关的患者层面的结局。这项基于证据的范围综述在“……”这一假设下，确定了所有关于偏头痛早期预防发作的现有临床试验证据。早期发作预防被定义为给药后30天内偏头痛预防获益。在PubMed、EMBASE和CINAHL数据库中检索了1988年至2020年期间的出版物。总体而言，16篇出版物描述了18项研究。所有研究均针对发作性/慢性偏头痛患者使用获批治疗方法（四种抗降钙素基因相关肽（CGRP）单克隆抗体和一种化学去神经支配剂）进行；未找到关于传统口服药物用于早期偏头痛预防的出版物。与安慰剂相比，erenumab（三项研究）在1周内减少了每周偏头痛天数；fremanezumab（六项研究）在第1天增加了至少中度严重程度无头痛的报告，并在1周内显著降低了偏头痛频率；galcanezumab（三项研究）在第1天和第一周的每一天显著降低了偏头痛患者的平均数量；eptinezumab（四项研究）在第1天使偏头痛发作可能性比基线降低>50%；而A型肉毒毒素（两项研究）在1周内减少了头痛和偏头痛天数。四篇出版物描述了早在第4周时功能、残疾和生活质量的改善；均未报告成本效益。抗CGRP单克隆抗体（erenumab、fremanezumab、galcanezumab和eptinezumab）以及一种化学去神经支配剂（A型肉毒毒素）在首个治疗周内提供了临床相关益处。关于偏头痛患者预防早期发作的临床相关益处的文献有限。
