Remenčiūtė Monika, Varžaitytė Greta, Žemgulytė Gintarė
Kaunas Hospital of the Lithuanian University of Health Sciences, Kaunas, Lithuania.
Lithuanian University of Health Sciences, Medical Academy, Faculty of Medicine, Department of Neurology, Kaunas, Lithuania.
Acta Med Litu. 2024;31(1):81-91. doi: 10.15388/Amed.2024.31.1.12. Epub 2024 Feb 27.
Migraine has a negative impact on patients' quality of life, with the frequency of attacks being associated with greater disability and poorer health status. Frequent migraine-type headaches require prophylactic treatment, which has so far been of limited effectiveness until advent of calcitonin gene-related peptide (CGRP) monoclonal antibody.
A prospective analysis was conducted of data from 41 migraine patients who experienced 4 or more monthly migraine days (MMD) longer than three months. At the beginning of the study, treatment with monoclonal antibodies against CGRP (fremanezumab 225 mg or erenumab 70 or 140 g per month) was prescribed according to the indications. The effect of the medications was evaluated after 3-month period.
The mean age of patients was 37.17 (±11.78) years. It was found that 17 patients (41.5%) had episodic migraine (EM) and 24 (58.5%) had chronic migraine (CM). Fremanezumab was prescribed to 26 patients (63.4%) and erenumab to 15 patients (36.6%); among the latter, 13 patients used 70 mg/month and 2 patients used 140 mg/month. Three months after treatment, CM changed to EM for 19 patients (79.2%), 27 patients (65.9%) had ≥50% reduction in the number of MMD and total migraine disability assessment (MIDAS) score was reduced by >50% in 31 patients (75.6%). Also, all areas of quality of life of patients were improved after 3 months continued treatment compared to baseline.
For more than half the patients using fremanezumab or erenumab after 3-month period, MMD decreased by ≥50% and total MIDAS score by >50 points. All areas of quality of life were improved after prophylactic treatment of migraine.
偏头痛对患者的生活质量有负面影响,发作频率与更高的残疾程度和更差的健康状况相关。频繁的偏头痛样头痛需要预防性治疗,在降钙素基因相关肽(CGRP)单克隆抗体出现之前,其有效性一直有限。
对41例每月偏头痛天数达4天或更多且持续超过3个月的偏头痛患者的数据进行前瞻性分析。在研究开始时,根据适应证给予抗CGRP单克隆抗体(每月225mg的夫瑞吉泮或70或140μg的依瑞奈尤单抗)治疗。3个月后评估药物疗效。
患者的平均年龄为37.17(±11.78)岁。发现17例患者(41.5%)为发作性偏头痛(EM),24例(58.5%)为慢性偏头痛(CM)。26例患者(63.4%)使用夫瑞吉泮,15例患者(36.6%)使用依瑞奈尤单抗;在后者中,13例患者每月使用70mg,2例患者每月使用140mg。治疗3个月后,19例患者(79.2%)的CM转变为EM,27例患者(65.9%)的每月偏头痛天数减少≥50%,31例患者(75.6%)的偏头痛残疾评估(MIDAS)总分降低>50%。此外,与基线相比,持续治疗3个月后患者生活质量的所有方面均得到改善。
在使用夫瑞吉泮或依瑞奈尤单抗3个月后,超过半数的患者每月偏头痛天数减少≥50%,MIDAS总分降低>50分。偏头痛预防性治疗后患者生活质量的所有方面均得到改善。