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. 2024 Jan 19;25(1):10.
doi: 10.1186/s10194-024-01715-4.

Calcitonin gene-related peptide antagonists in pregnancy: a disproportionality analysis in VigiBase®

Roberta Noseda  1 , Francesca Bedussi  1 , Claudio Gobbi  2   3   4 , Alessandro Ceschi  1   3   5   6 , Chiara Zecca  7   8
Affiliations

Calcitonin gene-related peptide antagonists in pregnancy: a disproportionality analysis in VigiBase®

Roberta Noseda et al. J Headache Pain. .

Abstract

Background: Current evidence on the safety of calcitonin gene-related peptide antagonists (CGRP-A) in pregnancy for the treatment of both episodic and chronic migraine is scarce and does not yet provide definitive information. By querying VigiBase®, the World Health Organization global pharmacovigilance database, this study aimed to detect differences in the reporting frequency between CGRP-A and triptans in relation to pregnancy.

Methods: Disproportionality analyses on de-duplicated safety reports collected in VigiBase® as of 31.05.2023 reporting exposure to CGRP-A in pregnancy with or without pregnancy outcomes. A Reporting Odds Ratio (ROR) with a 95% confidence interval (CI) was used as a measure of disproportionality and the threshold for the detection of a signal of disproportionate reporting was set with a 95% CI lower limit > 1.

Findings: Four hundred sixty-seven safety reports reported exposure to CGRP-A in pregnancy, mostly originating from the United States of America (360/467, 77%), more frequently reported by patients (225/467, 48%), who were mainly females (431/467, 92%), and more frequently reported exposure to CGRP-A during pregnancy (400/467, 86%). Compared to triptans, no signals of disproportionate reporting were detected with CGRP-A either for the overall reporting of pregnancy-related safety reports (ROR 0.91, 95% CI 0.78-1.06), for the reporting of pregnancy outcomes (maternal and/or foetal/neonatal, ROR 0.54, 95% CI 0.45-0.66), or for the reporting of foetal/neonatal outcomes (ROR 0.53, 95% CI 0.41-0.68).

Conclusions: This study showed that, to date, there are no signals of increased reporting with CGRP-A compared to triptans in relation to pregnancy in VigiBase®. Future pharmacovigilance studies are needed to confirm these findings.

Keywords: Calcitonin gene–related peptide antagonists; Disproportionality; Pregnancy; Safety; VigiBase.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Forest plot representation of the results of disproportionality analyses. Abbreviations: CGRP, calcitonin gene-related peptide; ROR, reporting odds ratio; CI, confidence interval; mAbs, monoclonal antibodies
See this image and copyright information in PMC

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