The Effect of Adding Calcitonin Gene‐Related Peptide Monoclonal Antibodies to Onabotulinum Toxin A Therapy on Headache Burden: A Retrospective Observational Case Series

2020 ◽  
Vol 60 (7) ◽  
pp. 1442-1443
Author(s):  
Seniha N. Ozudogru ◽  
Jared W. Bartell ◽  
Heidi Yuan ◽  
Kathleen B. Digre ◽  
Susan K. Baggaley
Keyword(s):  
Monoclonal Antibodies ◽  
Case Series ◽  
Calcitonin Gene Related Peptide ◽  
Toxin A ◽  
Related Peptide ◽  
Calcitonin Gene ◽  
Onabotulinum Toxin A

The Effect of Adding Calcitonin Gene-Related Peptide Monoclonal Antibodies to Onabotulinum Toxin A Therapy on Headache Burden: A Retrospective Observational Study

2020 ◽  
Author(s):  
Seniha Ozudogru ◽  
Jared Bartell ◽  
Heidi Yuan ◽  
Kathleen Digre ◽  
Susan Baggaley
Keyword(s):  
Monoclonal Antibodies ◽  
Chronic Migraine ◽  
Treatment Options ◽  
Calcitonin Gene Related Peptide ◽  
Toxin A ◽  
Beneficial Effects ◽  
Related Peptide ◽  
C Fibers ◽  
Calcitonin Gene ◽  
Onabotulinum Toxin A

Abstract Background The calcitonin gene-related peptide monoclonal antibody medications represent a novel and effective group of treatment options that can be added on to existing regimens such as onabotulinum toxin A injections for the treatment of refractory chronic migraine. Mechanistically, calcitonin gene-related peptide antibodies have been shown to inhibit Aδ fibers while onabotulinum toxin A modulates C fibers. Due to the differing loci of effect and anecdotal observations, a synergistic effect between these therapies is a theoretical possibility. The aim of this study was to investigate this relationship. Methods Patients from the University of Utah Headache Clinic having received at least two rounds of injections of onabotulinum toxin A who responded partially but not completely to therapy were started on a calcitonin gene-related peptide antibody medication. The patients’ responses to a brief headache burden questionnaire prior to their onabotulinum toxin A administration at the time of each visit were collected. Parameters we monitored included the number of headaches experienced while receiving onabotulinum toxin A therapy, the initial timing of the of the wear off period, and the number of headaches after that the wear off period began. Results Half of the 36 patients included in the study demonstrated an improvement in their headache burden based on at least one parameter from their questionnaire. These 18 patients reported an average increase of 2.0 additional weeks for the beneficial effects of the onabotulinum toxin A to wear off. Twelve patients reported no change in onabotulinum toxin A efficacy while 6 patients showed greater headache burden or lower onabotulinum toxin A treatment efficacy following the initiation of one of the monoclonal antibodies. Conclusions Our study highlights the potential of calcitonin gene-related peptide monoclonal antibodies to serve as an effective add-on therapy for chronic migraine patients receiving onabotulinum toxin A injections, especially those designated “responders” but still experiencing the drug wear off prior to the next round of injections. Larger sample sizes and more frequent at-home questionnaire data are needed to corroborate these results.

Early Experiences in Switching between Monoclonal Antibodies in Patients with Nonresponsive Migraine in Spain: A Case Series

2021 ◽  
pp. 1-4
Author(s):  
Ignacio Patier Ruiz ◽  
Javier Sánchez-Rubio Ferrández ◽  
Alba Cárcamo Fonfría ◽  
Teresa Molina García
Keyword(s):  
Clinical Trials ◽  
Monoclonal Antibodies ◽  
Therapeutic Targets ◽  
Case Series ◽  
Similar Efficacy ◽  
Migraine Prophylaxis ◽  
Therapeutic Failure ◽  
Related Peptide ◽  
Early Experiences ◽  
Calcitonin Gene

Monoclonal antibodies targeting the calcitonin gene-related peptide have been introduced into the therapeutic arsenal of migraine prophylaxis. Clinical trials report similar efficacy between them, and there is no evidence of switching to another one after failure. We aim to describe our experience in switching from erenumab to galcanezumab after therapeutic failure. We retrospectively reviewed 30 migraine patients who received monoclonal antibodies, with 15 of them switched after failure to achieve reduction in migraine days per month ≥30%. A ≥30% reduction in migraine days per month compared to baseline was observed in 8/15 (4/15 ≥ 50%) patients after switch. Some nonresponsive patients may benefit from switching between monoclonal antibodies with different therapeutic targets.

Calcitonin-Gene-Related Peptide (CGRP) Monoclonal Antibodies in Migraine Prevention; Literature Review

2021 ◽  
Vol 10 (1) ◽  
pp. 48-51
Author(s):  
Haneen Ahmed Khouja ◽  
Rawan Awadh Alshehri ◽  
Hussain Mirza Alhalal ◽  
Hassan Dhafer Alabisi ◽  
Salhah Mohammad Alajmi ◽  
...  
Keyword(s):  
Monoclonal Antibodies ◽  
Literature Review ◽  
Calcitonin Gene Related Peptide ◽  
Migraine Prevention ◽  
Related Peptide ◽  
Calcitonin Gene

Monoclonal antibodies distinguishing α and β forms of calcitonin gene-related peptide

1990 ◽  
Vol 134 (1) ◽  
pp. 87-94 ◽  
Author(s):  
D.P. Andrew ◽  
T.D. Bidgood ◽  
C. Bose ◽  
D. Brown ◽  
G. Galfre ◽  
...  
Keyword(s):  
Monoclonal Antibodies ◽  
Calcitonin Gene Related Peptide ◽  
Related Peptide ◽  
Calcitonin Gene

Safety and tolerability of calcitonin-gene-related peptide binding monoclonal antibodies for the prevention of episodic migraine – a meta-analysis of randomized controlled trials

Cephalalgia ◽  
2019 ◽  
Vol 39 (9) ◽  
pp. 1164-1179 ◽  
Author(s):  
Da Xu ◽  
Deng Chen ◽  
Li-na Zhu ◽  
Ge Tan ◽  
Hai-jiao Wang ◽  
...  
Keyword(s):  
Monoclonal Antibodies ◽  
Adverse Events ◽  
Injection Site ◽  
Meta Analysis ◽  
Peptide Binding ◽  
Episodic Migraine ◽  
Calcitonin Gene Related Peptide ◽  
Serious Adverse Events ◽  
Related Peptide ◽  
Calcitonin Gene

Aim To systematically evaluate the safety and tolerability of calcitonin-gene-related peptide binding monoclonal antibodies from the results of randomized controlled trials. Methods Online databases were searched on calcitonin-gene-related peptide binding monoclonal antibodies for the prevention of episodic migraine. Overall withdrawal, withdrawal due to adverse events, adverse events, serious adverse events and specific adverse events were extracted from the included studies. A meta-analysis was performed with Revman 5.3.0 software. Results Ten studies that investigated four drugs (galcanezumab, erenumab, fremanezumab and eptinezumab) with 5817 participants were included in this study. Serious adverse events, overall withdrawals, withdrawal due to adverse events and any adverse events were not significantly associated with monoclonal antibody treatment. Injection site pain and erythema were significantly higher in the calcitonin-gene-related peptide binding monoclonal antibodies treatment group than in the placebo group. The rates of serious adverse events were significantly higher in the galcanezumab 120 mg group. Injection site erythema was associated with galcanezumab 120 mg and 240 mg. Injection site pain and nasopharyngitis were associated with galcanezumab 150 mg and 5 mg, respectively. Overall adverse events were significantly higher with erenumab 70 mg and 140 mg. Treatment-related adverse events were significantly higher with fremanezumab 225 mg/month and 675 mg/quarter. Conclusions This study provides data on the safety and tolerability profiles of calcitonin-gene-related peptide binding monoclonal antibodies and confirms their potential use as preventive treatments for episodic migraine. In addition to the acceptable withdrawal rates, serious adverse events were rare, and the severity of most adverse events was mild to moderate. Injection site reaction may be the major adverse event associated with galcanezumab.

scholarly journals New Trends in Migraine Pharmacology: Targeting Calcitonin Gene–Related Peptide (CGRP) With Monoclonal Antibodies

2019 ◽  
Vol 10 ◽  
Author(s):  
Damiana Scuteri ◽  
Annagrazia Adornetto ◽  
Laura Rombolà ◽  
Maria Diana Naturale ◽  
Luigi Antonio Morrone ◽  
...  
Keyword(s):  
Monoclonal Antibodies ◽  
Calcitonin Gene Related Peptide ◽  
Related Peptide ◽  
Calcitonin Gene
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