Acute Medication Use in Patients With Migraine Treated With Monoclonal Antibodies Acting on the CGRP Pathway: Results From a Multicenter Study and Proposal of a New Index

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Introduction: Assessing the impact of migraine preventive treatments on acute medication consumption is important in clinical evaluation. The number of acute medication intakes per each monthly migraine day (MMD) could provide insights on migraine burden and represent a new proxy of treatment effectiveness in clinical trials and real-life studies. We evaluated celý popis

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Hlavní autor
Lucia Sette
Další autoři
Valeria Caponnetto, Raffaele Ornello, Tomáš Nežádal, Dana Čtrnáctá, Jitka Šípková, Zuzana Matoušová, Simona Sacco
Typ dokumentu
Články
Publikováno v
Frontiers in neurology. -- ISSN 1664-2295. -- Roč. 13, č. - (2022), s. 846717
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100 1 |a Sette, Lucia  |u Neuroscience Section, Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, L'Aquila, Italy 
245 1 0 |a Acute Medication Use in Patients With Migraine Treated With Monoclonal Antibodies Acting on the CGRP Pathway: Results From a Multicenter Study and Proposal of a New Index /  |c L. Sette, V. Caponnetto, R. Ornello, T. Nežádal, D. Čtrnáctá, J. Šípková, Z. Matoušová, S. Sacco 
520 9 |a Introduction: Assessing the impact of migraine preventive treatments on acute medication consumption is important in clinical evaluation. The number of acute medication intakes per each monthly migraine day (MMD) could provide insights on migraine burden and represent a new proxy of treatment effectiveness in clinical trials and real-life studies. We evaluated the effect of monoclonal antibodies acting on calcitonin gene-related peptide (CGRP) pathway on the consumption of migraine acute medication in real-life. Methods: In two headache centers in Prague (CZ), we included and followed up to 6 months consecutive patients treated with MoAbs acting on CGRP (erenumab or fremanezumab). For each month of treatment, we reported monthly drug intake (MDI) in doses of any medication, migraine-specific (MS), and non-migraine-specific (non-MS) medications, and computed a ratio between MMDs and MDI, i.e., Migraine Medication Index (MMI) for MS and non-MS medications. Results: We included 90 patients (91.1% women) with a median age of 47 [interquartile range (IQR) 42-51] years; 81 (90.0%) treated with erenumab and 9 (10.0%) with fremanezumab. Median MMDs decreased from 11 (IQR 8-14) at baseline to 4 (IQR 2-5) at Month 3 (p < 0.001 vs. baseline) and 3 (IQR 2-6) at Month 6 (p < 0.001 vs. baseline). Median MDI decreased from 15 drug intakes (IQR 11-20) at baseline to four drug intakes (IQR 2-7) at Month 3 (p < 0.001) and four drug intakes (IQR 2-7) at Month 6 (p < 0.001).The corresponding MDIs for MS medications were 10 (IQR 6-14) at baseline, 3 (IQR 1-5, p < 0.001) at Month 3, and 2 (IQR 0-4, p < 0.001) at Month 6. Monthly drug intakes for non-MS medications were 4 (IQR 0-9) at baseline, 1 (IQR 0-3, p < 0.001) at Month 3 and at Month 6.Median MMI decreased from 1.32 (IQR 1.11-1.68) at baseline to 1.00 (IQR 1.00-1.50, p < 0.001) at Month 3 and 1.00 (IQR 1.00-1.34, p < 0.001) at Month 6. Conclusions: We confirmed that MoAbs acting on CGRP pathway decrease acute migraine medication consumption. We proposed a new index that can be easily applied in clinical practice to quantify migraine burden and its response to acute medication. Our index could help optimizing migraine acute treatment in clinical practice.  
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700 1 |a Caponnetto, Valeria  |u Neuroscience Section, Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, L'Aquila, Italy 
700 1 |a Ornello, Raffaele  |u Neuroscience Section, Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, L'Aquila, Italy 
700 1 |a Nežádal, Tomáš  |u Department of Neurology, 1st Faculty of Medicine, Military University Hospital Prague, Charles University, Prague, Czechia 
700 1 |a Čtrnáctá, Dana  |u Department of Neurology, 1st Faculty of Medicine, Military University Hospital Prague, Charles University, Prague, Czechia 
700 1 |a Šípková, Jitka  |u Department of Neurology, 1st Faculty of Medicine, Military University Hospital Prague, Charles University, Prague, Czechia 
700 1 |a Matoušová, Zuzana  |u Department of Neurology, 2nd Faculty of Medicine, Motol University Hospital Prague, Charles University, Prague, Czechia 
700 1 |a Sacco, Simona  |u Neuroscience Section, Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, L'Aquila, Italy 
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