依瑞奈单抗、佛来美曲坦和加兰他敏在减少慢性偏头痛患者药物过度使用性头痛的有效性概述。

Overview on effectiveness of erenumab, fremanezumab, and galcanezumab in reducing medication overuse headache in chronic migraine patients.

机构信息

Casa Di Cura Privata del Policlinico Igea Headache Center, Via Marcona 69, 20129, Milan, Italy.

Dental and Oral Surgery, Headache and Facial Pain Center Fondazione, IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, via Francesco Sforza 35, 20122, Milan, Italy.

出版信息

Neurol Sci. 2022 Sep;43(9):5759-5761. doi: 10.1007/s10072-022-06265-8. Epub 2022 Jul 14.

DOI:10.1007/s10072-022-06265-8

PMID:35836032

Abstract

BACKGROUND

Migraine is a disabling primary headache disorder with socioeconomic burden. Medication overuse headache (MOH) is caused by chronic overuse of symptomatic drugs often observed in migraine patients. The approved for migraine prevention CGRP antagonists erenumab, fremanezumab, and galcanezumab are effective in migraine prophylaxis but there are only few data regarding efficacy on MOH.

AIM OF THE STUDY

To assess efficacy of erenumab, galcanezumab, and fremanezumab in reducing headache in patients with chronic migraine complicated by medication overuse headache.

METHODS

Patients fitting International Classification of Headache Disorders 3rd Edition criteria for chronic migraine and MOH were enrolled and treated with CGRP antagonists without performing drug withdrawal. Efficacy was assessed by improvement of Migraine Impact and Disability Assessment Scale (MIDAS) and reduction of monthly use of symptomatic medications. Patients reporting a ≥ 50% reduction of monthly headache days and ≥ 50% reduction of analgesic and/or triptan use compared with a 3-month baseline period were defined as responders.

RESULTS

Three hundred three patients, 252 females and 51 males, were enrolled. Patients were treated for at least 6 months up to 1 year. Two hundred forty-two out of 303 (80%) showed both a ≥ 50% reduction of monthly headache days and analgesics intake at 3-month follow-up visit compared to the 3-month baseline period; 239 on 303 (78.8%) continued to have ≥ 50% improvement in both at 6-month follow-up visit.

CONCLUSION

Monoclonal antibodies inhibiting CGRP are effective in reducing monthly headache days in migraine patients with MOH.

摘要

背景

偏头痛是一种具有社会经济负担的致残性原发性头痛障碍。药物过度使用性头痛（MOH）是由经常在偏头痛患者中观察到的症状性药物的慢性过度使用引起的。批准用于偏头痛预防的 CGRP 拮抗剂依那西普单抗、弗里美昔单抗和加兰尼单抗在偏头痛预防方面有效，但关于它们对 MOH 的疗效的数据很少。

研究目的

评估依那西普单抗、加兰尼单抗和弗里美昔单抗在减少慢性偏头痛合并药物过度使用性头痛患者头痛方面的疗效。

方法

符合国际头痛疾病分类第 3 版标准的慢性偏头痛和 MOH 患者入组，并在不进行药物戒断的情况下接受 CGRP 拮抗剂治疗。通过偏头痛影响和残疾评估量表（MIDAS）的改善和每月使用症状性药物的减少来评估疗效。与 3 个月基线期相比，报告每月头痛天数减少≥50%和/或镇痛药和/或曲普坦类药物使用减少≥50%的患者被定义为应答者。

结果

303 例患者，252 例女性和 51 例男性入组。患者至少接受了 6 个月至 1 年的治疗。242 例（80%）在 3 个月随访时与 3 个月基线期相比，每月头痛天数和镇痛药摄入量均显示出≥50%的减少；303 例中的 239 例（78.8%）在 6 个月随访时仍保持每月头痛天数和镇痛药摄入量均有≥50%的改善。