Two‐Hour CGRP Infusion Causes Gastrointestinal Hyperactivity: Possible Relevance for CGRP Antibody Treatment

Katrine Falkenberg; Helene Rønde Bjerg; Jes Olesen

doi:10.1111/head.13795

Impaired wound healing in a migraine patient as a possible side effect of calcitonin gene-related peptide receptor antibody treatment: A case report

Cephalalgia ◽

10.1177/0333102420933571 ◽

2020 ◽

Vol 40 (11) ◽

pp. 1255-1260

Author(s):

Sebastian Wurthmann ◽

Steffen Nägel ◽

Eva Hadaschik ◽

Swantje Schlott ◽

Armin Scheffler ◽

...

Keyword(s):

Wound Healing ◽

Side Effects ◽

Migraine Patient ◽

Calcitonin Gene Related Peptide ◽

Antibody Treatment ◽

Impaired Wound Healing ◽

Receptor Antibody ◽

Related Peptide ◽

Calcitonin Gene ◽

Cgrp Antibody

Introduction Wound healing disturbances as possible side effects of calcitonin gene-related peptide (CGRP) antibody treatment have been discussed previously but not yet described in humans. Basic research suggests that calcitonin gene-related peptide plays an important role in keratinocyte migration, vascularization and immune response and lack of calcitonin gene-related peptide may lead to impaired wound healing. Case A 51-year-old female migraine patient was treated with the CGRP receptor antibody erenumab for 6 months, which led to a relevant reduction of migraine days. During the treatment, two periods of severely impaired wound healing occurred after a trivial skin injury without spatial relation to the injection site. Skin biopsy confirmed a deep perivascular and interstitial lymphohistiocytic infiltrate with admixed eosinophils, ulceration of the epithelium, a heavy edema of the papillary dermis and focally thrombosed vessels. Conclusion Impaired wound healing might be relevant side effects of CGRP antibody therapy and anamnesis within the course of treatment should also include possible observation of impaired wound healing or planned surgery.

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CGRP antibody therapy in patients with drug resistant migraine and chronic daily headache: a real-world experience

The Journal of Headache and Pain ◽

10.1186/s10194-021-01323-6 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Armin Scheffler ◽

Hannah Schenk ◽

Sebastian Wurthmann ◽

Michael Nsaka ◽

Christoph Kleinschnitz ◽

...

Keyword(s):

Chronic Daily Headache ◽

Antibody Therapy ◽

Routine Data ◽

Wilcoxon Test ◽

P Value ◽

Drug Resistant ◽

Antibody Treatment ◽

Daily Headache ◽

Low Responder ◽

Cgrp Antibody

Abstract Background Calcitonin gene-related peptide (CGRP) (receptor) antibodies (erenumab, fremanezumab and galcanezumab) are increasingly used in prophylactic treatment of migraine. In the approval studies, severely affected patients with migraine and chronic daily headache without any headache free days were excluded. Thus, less is known about the effectiveness of CGRP antibody treatment in this cohort. Methods Clinical routine data of 32 patients with migraine and daily headache were analysed after three months of treatment with a CGRP antibody (16 erenumab, 7 galcanezumab, 9 fremanezumab), including changes of monthly headache days (MHD) monthly migraine days (MMD) and monthly acute medication intake (AMD) as well as migraine characteristics. Statistical analysis was performed with the Wilcoxon-Test. Migraine characteristics were analysed descriptively. Results The number of MHD was significantly reduced (mean reduction (standard error), p-value): (-4.2 (1.3), p = 0.009) as well as MMD (-4.3 (1.6), p = 0.033). Four patients (13 %) reached a 50 % reduction regarding MHD and 8 patients (25 %) regarding MMD, migraine duration and intensity improved under therapy. Conclusions Despite the low responder rate, CGRP antibodies can be effective at least in a few cases of severely affected patients with drug resistant migraine and chronic daily headache. Trial registration Retrospective registered.

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