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. 2023 Dec 1;62(23):3455-3460.
doi: 10.2169/internalmedicine.1471-22. Epub 2023 Apr 14.

Early Effect of Calcitonin Gene-related Peptide Monoclonal Antibodies in Migraine with Medication Overuse: A Single-center Retrospective Study

Yasuo Ito  1 , Takashi Mitsufuji  1 , Mariko Okada  1 , Shugo Fujita  1 , Ryu Yokoyama  1 , Hitoshi Kawasaki  1 , Toshimasa Yamamoto  1
Affiliations

Early Effect of Calcitonin Gene-related Peptide Monoclonal Antibodies in Migraine with Medication Overuse: A Single-center Retrospective Study

Yasuo Ito et al. Intern Med. .

Abstract

Objective Calcitonin gene-related peptide (CGRP)-(receptor) monoclonal antibody (mAb) has been reported to reduce the frequency of medication overuse in patients with migraine. The present study investigated whether or not CGRP-mAb treatment shows early effectiveness for medication overuse headache (MOH) in Japan. Methods We retrospectively reviewed 34 patients with MOH who received preventive treatment with CGRP-mAb from June 2021 to October 2022. The International Classification of Headache Disorders, 3rd edition was used to diagnose MOH. This study was conducted at the Department of Neurology, Saitama Medical University. Patients were recruited from this specialized headache outpatient center. Results In total, 69 patients with migraine had newly introduced CGRP-mAb, and 34 patients had MOH (49.3%). The mean±standard deviation patient age was 44±15.5 years old. The study population included 24 women (70.6%). The types of CGRP-mAb used were galcanezumab in 16 patients (47.0%), fremanezumab in 10 (29.4%), and erenumab in 8 (23.5%). The mean disease duration was 19.6±13.1 years. The types of migraine diagnosis were chronic migraine in 28 patients (82.4%) and migraine with aura in 11 patients (32.4%). The mean number of headache days in the month before administration of CGRP-mAb was 22±7.7 days; 1 month after administration, the MHD was 16.9±9.1 days. The change in MHD was -5.7 days (22.7%), indicating significant improvement (p<0.05). Conclusion CGRP-mAb has been suggested as a preventive treatment for patients with MOH. Further investigation of the long-term efficacy of CGRP-mAb for MOH is needed.

Keywords: calcitonin gene-related peptide monoclonal antibody; medication overuse; medication overuse headache; migraine.

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Conflict of interest statement

Author's disclosure of potential Conflicts of Interest (COI).

Yasuo Ito: Honoraria, Daiichi Sankyo and Otsuka Pharmaceutical. Toshimasa Yamamoto: Honoraria, Daiichi Sankyo, Eli Lilly Japan, Otsuka Pharmaceutical and Amgen Astellas BioPharma.

Figures

Figure 1.
Figure 1.
Change in mean number of headache days (MHD) in the month before and after administration of all types of calcitonin gene-related peptide monoclonal antibody (CGRP-mAb).
Figure 2.
Figure 2.
Recovery rate for mean number of headache days (MHD) in groups that switched and did not switch to another calcitonin gene-related peptide monoclonal antibody (CGRP-mAb).
Figure 3.
Figure 3.
Rates of switching among the three types of calcitonin gene-related peptide monoclonal antibody (CGRP-mAb).
Figure 4.
Figure 4.
Change in the mean number of headache days (MHD) in the month before and after administration of galcanezumab.
Figure 5.
Figure 5.
Change in the mean number of headache days (MHD) in the month before and after administration of fremanezumab.
Figure 6.
Figure 6.
Change in the mean number of headache days (MHD) in the month before and after administration of erenumab.
See this image and copyright information in PMC

References

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