Muddam Meghana Reddy, Obajeun Omobolanle A, Abaza Abdelrahman, Jaramillo Arturo P, Sid Idris Faten, Anis Shaikh Humna, Vahora Ilma, Moparthi Kiran Prasad, Al Rushaidi Majdah T, Nath Tuheen Sankar
General Practice, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.
Pediatrics, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.
Cureus. 2023 Sep 19;15(9):e45560. doi: 10.7759/cureus.45560. eCollection 2023 Sep.
The neuropeptide calcitonin gene-related peptide (CGRP) is an essential pathophysiological treatment for migraines. A unique class of medications called CGRP monoclonal antibodies target CGRP and its receptor and have demonstrated promising benefits in the treatment and prevention of migraines. This study sought to identify and assess the quality of existing systematic reviews about the effectiveness of CGRP antibodies for preventing migraines, as well as systematically review and synthesize the evidence on these topics. This included the four Food and Drug Administration (FDA)-approved medications erenumab, galcanezumab, fremanezumab, and eptinezumab. The effectiveness and safety of these monoclonal antibodies in preventing migraines should also be examined in light of patient characteristics, and any gaps in the body of knowledge should be noted in order to suggest new lines of investigation. Data gathering included a thorough search of internet databases (PubMed, Cochrane Library, Web of Science, and Scopus) for relevant research released between 2018 and 2023. The findings imply that CGRP monoclonal antibodies are efficient and secure for preventing migraines and may be considered a first-line alternative for treating migraines and drug misuse. The results further imply that combination treatment with CGRP antibodies and onabotulinumtoxinA may enhance the prevention of migraine in adults. With suggestions for more studies to find and address these variables, the significance of genetic and epigenetic factors in the progression of pediatric patients' acute postoperative pain to chronic postsurgical pain is underlined. All four anti-CGRP monoclonal antibodies, erenumab, fremanezumab, galcanezumab, and eptinezumab, were shown to be safe and effective for the prevention of migraine when the research additionally looked at their individual effectiveness and safety. Additionally, the study discovered considerable variances in effectiveness amongst various groups. However, further investigation is required to establish the best time and dosage and the effect of patient characteristics on the effectiveness and safety of these medications.
神经肽降钙素基因相关肽（CGRP）是偏头痛的一种重要病理生理治疗方法。一类名为CGRP单克隆抗体的独特药物靶向CGRP及其受体，并已在偏头痛的治疗和预防中显示出有前景的益处。本研究旨在识别和评估关于CGRP抗体预防偏头痛有效性的现有系统评价的质量，并系统评价和综合这些主题的证据。这包括四种美国食品药品监督管理局（FDA）批准的药物：erenumab、galcanezumab、fremanezumab和eptinezumab。还应根据患者特征检查这些单克隆抗体预防偏头痛的有效性和安全性，并指出知识体系中的任何空白，以便提出新的研究方向。数据收集包括全面搜索互联网数据库（PubMed、Cochrane图书馆、科学网和Scopus），以查找2018年至2023年期间发布的相关研究。研究结果表明，CGRP单克隆抗体在预防偏头痛方面是有效且安全的，可被视为治疗偏头痛和药物滥用的一线选择。结果还表明，CGRP抗体与A型肉毒毒素联合治疗可能会增强成人偏头痛的预防效果。强调了遗传和表观遗传因素在儿科患者急性术后疼痛向慢性术后疼痛进展中的重要性，并建议进行更多研究以发现和解决这些变量。当研究进一步考察其各自的有效性和安全性时，所有四种抗CGRP单克隆抗体erenumab、fremanezumab、galcanezumab和eptinezumab在预防偏头痛方面均显示出安全有效。此外，研究发现不同组之间在有效性方面存在显著差异。然而，需要进一步研究以确定最佳时间和剂量以及患者特征对这些药物有效性和安全性的影响。
