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Safety and effectiveness of CGRP monoclonal antibodies for migraine patients

CGRP monoclonal antibodies CGRP monoclonal antibodies
CGRP monoclonal antibodies CGRP monoclonal antibodies

The objective of a network meta-analysis was to compare the efficacy of various calcitonin gene-related peptide (CGRP)-binding monoclonal antibodies (mAbs) for migraine sufferers.

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Key take away

Galcanezumab 240 mg, Fremanezumab monthly, and Eptinezumab 300 mg seem to be the three most effective CGRP monoclonal antibodies for treating migraine patients who have experienced prior therapy failures.

Background

The objective of a network meta-analysis was to compare the efficacy of various calcitonin gene-related peptide (CGRP)-binding monoclonal antibodies (mAbs) for migraine sufferers.

Method

A number of internet databases including ClinicalTrials.gov, Cochrane Library, Ovid EMBASE, and Ovid MEDLINE were thoroughly searched. Randomized clinical trials that evaluated any CGRP mAb  in adult migraine patients with previously failed therapy were considered. The major safety endpoint was treatment-emergent adverse events (TEAEs), and change in monthly migraine days (MMDs) was the primary effectiveness outcome.

Result

Overall, 3052 volunteers from 7 trials were incorporated. According to a three-node analysis, CGRP mAbs were more effective than CGRP receptor mAbs at lowering MMDs (Mean difference [MD]: -1.55) and boosting response rates by at least 50% (Risk Ratio [RR]: 1.52). Notably, 240 mg Galcanezumab was the most effective treatment in terms of lowering MMDs (MD -4.40) and raising 50% response rates (RR: 4.18).

Additionally, a treatment regimen containing 300 mg of Fremanezumab or Eptinezumab offered a considerable benefit over 140 mg of Erenumab in terms of an increased response rate of a minimum of 50%. In none of the comparisons did the study reveal a difference in TEAEs and serious adverse events occurrences.

Conclusion

The best choice to treat migraine with prior treatment failures seems to be 300 mg Eptinezumab, monthly Fremanezumab, and 240 mg Galcanezumab.

Source:

The Journal of Headache and Pain

Article:

Efficacy and safety of monoclonal antibody against calcitonin gene-related peptide or its receptor for migraine patients with prior preventive treatment failure: a network meta-analysis

Authors:

Xing Wang et al.

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