Vollono Catello, Romozzi Marina, Munafò Antonio, Vigani Giulia, De Cesaris Francesco, Calabresi Paolo, Iannone Luigi Francesco
Dipartimento Universitario di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy.
Neurologia, Dipartimento di Neuroscienze, Organi di Senso e Torace, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
J Neurol. 2025 Jun 19;272(7):468. doi: 10.1007/s00415-025-13202-0.
This study aimed to compare the differences in clinical characteristics and response to monoclonal antibodies against CGRP (anti-CGRP mAbs) between patients who habitually used triptans (TRIPTANS group) and patients who were non-current users (NO-TRIPTANS group).
In this prospective cohort study, all consecutive outpatients treated with anti-CGRP mAbs for 12 months were included. Clinical data were collected at baseline and monthly: number of headache days (MHDs), the absolute number of analgesics (AMNs), and the number of days with at least one analgesic (AMDs), Headache Impact Test-6 (HIT-6), and Migraine Disability Assessment (MIDAS) questionnaires. The outcomes were to evaluate the differences between TRIPTANS and NO-TRIPTANS groups (users or non-users of triptans in the 6 months before and during anti-CGRP mAb treatment) in MHDs and the other clinical variables during treatment. Response rates were assessed based on reductions in MHDs (≤ 25%, ≥ 50%, ≥ 75%).
A total of 336 patients treated with mAbs were included. At baseline, NO-TRIPTANS group had higher MHDs (24.7 ± 6.7) compared to the TRIPTANS group (21.8 ± 6.9), p < 0.001. Comparative and normalized analyses showed significant and sustained lower MHDs in the TRIPTANS group during treatment. The MIDAS score was also significantly lower in the TRIPTANS group at month-3, 6, 9, 12, and lower AMDs and AMNs compared to NO-TRIPTANS group were seen in most of the time-points. The number of patients with ≥ 50% reduction of MHDs was significantly higher in the TRIPTANS group at months 1 and 12.
This study showed greater effectiveness of anti-CGRP mAb in habitual triptans users, possibly due to a common and/or synergistic action.
本研究旨在比较习惯性使用曲坦类药物的患者（曲坦类药物组）和非当前使用者（非曲坦类药物组）之间的临床特征差异以及对降钙素基因相关肽单克隆抗体（抗CGRP单克隆抗体）的反应。
在这项前瞻性队列研究中，纳入了所有连续接受抗CGRP单克隆抗体治疗12个月的门诊患者。在基线和每月收集临床数据：头痛天数（MHDs）、镇痛药绝对使用量（AMNs）、至少使用一种镇痛药的天数（AMDs）、头痛影响测试-6（HIT-6）和偏头痛残疾评估（MIDAS）问卷。研究结果是评估曲坦类药物组和非曲坦类药物组（在抗CGRP单克隆抗体治疗前6个月及治疗期间使用或未使用曲坦类药物）在治疗期间MHDs及其他临床变量的差异。基于MHDs的降低情况（≤25%、≥50%、≥75%）评估反应率。
共纳入336例接受单克隆抗体治疗的患者。在基线时，非曲坦类药物组的MHDs（24.7±6.7）高于曲坦类药物组（21.8±6.9），p<0.001。比较分析和标准化分析显示，治疗期间曲坦类药物组的MHDs显著且持续降低。在第3、6、9、12个月时，曲坦类药物组的MIDAS评分也显著更低，并且在大多数时间点，与非曲坦类药物组相比，其AMDs和AMNs更低。在第1个月和第12个月时，MHDs降低≥50%的曲坦类药物组患者数量显著更多。
本研究表明抗CGRP单克隆抗体在习惯性使用曲坦类药物的患者中疗效更佳，可能是由于共同和/或协同作用。
