Katsuki Masahito, Kashiwagi Kenta, Kawamura Shin, Koh Akihito
Department of Neurosurgery, Itoigawa General Hospital, Itoigawa, JPN.
Department of Neurology, Itoigawa General Hospital, Itoigawa, JPN.
Cureus. 2023 Jan 12;15(1):e33689. doi: 10.7759/cureus.33689. eCollection 2023 Jan.
Introduction Adolescent migraines is a public health problem, and effective prophylactic treatment is needed. In Japan, three types of calcitonin gene-related peptide-related monoclonal antibodies (CGRP-mABs) are available. Galcanezumab, fremanezumab, and erenumab can be used for migraine prevention in ages 15 years or older, but reports on adolescent migraine treated with CGRP-mABs remain few. We described this study to report the real-world data of CGRP-mABs' efficacy for adolescents with migraines aged from 15 to 17 years old. Methods We retrospectively investigated ten adolescent migraine patients aged from 15 to 17 years old treated with CGRP-mABs. Headache impact test-6 (HIT-6), monthly headache days (MHD), and monthly acute medication intake days (AMD) before and three months after CGRP-mABs treatment were evaluated. Results Six females and four males were included. Seven had episodic migraines (EM), three had EM and tension-type headaches, one had chronic migraines (CM), and one had CM and medication-overuse headaches. As chief obstacles to life due to headaches, five reported them as detrimental to study, one reported them as detrimental to playing sports, and four reported missing school. The median HIT-6 was 63 (46-68) and 44 (36-65) before and three months after treatment, respectively. Median of MHD was 5.5 (1-29) and 1.5 (1-30), respectively, and the median of AMD was 5.5 (1-30) and 1 (0-30), respectively. A significant reduction of HIT-6 was observed at three months (p=0.008). Six (60%) of the ten patients experienced therapeutic effectiveness. Patients with missing school as the chief obstacle to life due to headaches seemed ineffective compared to those with other obstacles (p=0.048). There were no side effects of CGRP-mABs. Conclusion We herein described the ten adolescent migraine patients treated with CGRP-mABs. HIT-6 score significantly decreased at three months, and six of the ten patients experienced therapeutic effectiveness measured by HIT-6. Now several trials have been ongoing to test the efficacy of CGRP-mABs for adolescents. Urgent evidence accumulation is needed about CGRP-mABs for adolescents.
引言 青少年偏头痛是一个公共卫生问题，需要有效的预防性治疗。在日本，有三种降钙素基因相关肽相关单克隆抗体（CGRP - mABs）可供使用。加卡尼单抗、夫瑞内单抗和依瑞奈单抗可用于预防15岁及以上青少年的偏头痛，但关于使用CGRP - mABs治疗青少年偏头痛的报道仍然很少。我们开展本研究以报告CGRP - mABs对15至17岁青少年偏头痛患者疗效的真实世界数据。
方法 我们回顾性调查了10例接受CGRP - mABs治疗的15至17岁青少年偏头痛患者。评估了CGRP - mABs治疗前及治疗三个月后的头痛影响测试 - 6（HIT - 6）、每月头痛天数（MHD）和每月急性药物摄入天数（AMD）。
结果 纳入6名女性和4名男性。7例患有发作性偏头痛（EM），3例患有EM和紧张型头痛，1例患有慢性偏头痛（CM），1例患有CM和药物过量使用性头痛。作为因头痛导致生活的主要障碍，5例报告其对学习有不利影响，1例报告其对运动有不利影响，4例报告缺课。治疗前和治疗三个月后HIT - 6的中位数分别为63（46 - 68）和44（36 - 65）。MHD的中位数分别为5.5（1 - 29）和1.5（1 - 30），AMD的中位数分别为5.5（1 - 30）和1（0 - 30）。在三个月时观察到HIT - 6有显著降低（p = 0.008）。10例患者中有6例（60%）有治疗效果。因头痛导致生活的主要障碍是缺课的患者与有其他障碍的患者相比似乎效果不佳（p = 0.048）。CGRP - mABs没有副作用。
结论 我们在此描述了10例接受CGRP - mABs治疗的青少年偏头痛患者。三个月时HIT - 6评分显著降低，10例患者中有6例经HIT - 6测量有治疗效果。目前有几项试验正在进行以测试CGRP - mABs对青少年的疗效。迫切需要积累关于CGRP - mABs用于青少年的证据。
