A recent real-world clinical practice study published in the Journal of Neurology concluded the use of monoclonal antibodies against calcitonin gene-related peptide (CGRP) therapy to be effective in patients with refractory migraine.

To examine the frequency and headache-related impact response to monoclonal antibodies against CGRP, a total of 155 patients with monthly ≥ 8 headache days (with unsuccessful response to a minimum of 3 preventive medicines like erenumab and galcanezumab) were considered. These patients were asked to fill an electronic headache diary comprising of number of headache and migraine days in a month, headache pain intensity (numerical scale) and analgesics usage. The Patient-Reported Outcome questionnaires at starting of therapy and following 12 weeks were also completed. On the basis of improvement in the frequency of headache and migraine, the patients were categorized into ≥ 50%, ≥ 75% and 100% responders.

A reduction in headache frequency as - 9.1 headache days per month and - 8.5 migraine days per month was observed after 12 weeks of the treatment. The number of patients who described  ≥ 50%, ≥ 75% and 100% headache and migraine days per month decrease has been portrayed in the following table:

Distinct improvements were witnessed for all patient-reported outcomes in the ≥ 50% migraine days/month-responders group. Less severe disability was noted in patients who were not on other preventive medicines and a higher percentage of monthly migraine over headache days were more probably associated with ≥ 50% migraine days per month-responder. Constipation (20%), fatigue (7.1%) and a temporary rise in blood pressure (5.2%) were most frequently recorded adverse events.