Galcanezumab for the Prevention of Migraine

Frerichs, Lindsay M; Friedman, Deborah I.

doi:10.2217/pmt-2020-0030

Cited by 4 publications

(2 citation statements)

References 55 publications

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“…CGRP is expressed in the trigeminal ganglion and is increased in the cranial venous outflow during acute migraine attacks. Specific antibodies either targeting the CGRP ligand (galcanezumab [ 7 ], fremanezumab [ 8 ], eptinezumab [ 9 ]) or the receptor (erenumab [ 10 ]) were developed and approved by the Food and Drug Administration (FDA) and European Medicines Agency (EMA). The diverse mechanisms of action of CGRP receptor versus ligand monoclonal antibodies may differentially affect efficacy, safety, and/or tolerability in migraine patients.…”

Section: Introductionmentioning

confidence: 99%

Real-world effectiveness of fremanezumab in patients with migraine switching from another mAb targeting the CGRP pathway: a subgroup analysis of the Finesse Study

et al. 2023

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Background Monoclonal antibodies targeting the CGRP pathway are effective and safe for prophylactic treatment of episodic (EM) and chronic migraine (CM). In case of treatment failure of a CGRP pathway targeting mAb, physician has to decide whether using another anti-CGRP pathway mAb is useful. This interim analysis of Finesse Study evaluates effectiveness of the anti-CGRP mAb fremanezumab in patients with a history of other prior anti-CGRP pathway mAb treatments (switch patients). Methods Finesse, a non-interventional, prospective, multicentre, two-country (Germany-Austria) study observing migraine patients receiving fremanezumab in clinical routine. This subgroup analysis presents data on documented effectiveness over 3 months after the first dose of fremanezumab in switch patients. Effectiveness was evaluated based on reduction in average number of migraine days per month (MMDs), MIDAS and HIT-6 scores changes as well as in number of monthly days with acute migraine medication use. Results One hundred fifty-three out of 867 patients with a history of anti-CGRP pathway mAb treatment prior to initiation of fremanezumab were analysed. Switch to fremanezumab led to ≥ 50% MMD reduction in 42.8% of migraine patients, with higher response rate in EM (48.0%) than in CM patients (36.5%). A ≥ 30% MMD reduction was achieved by 58.7% in CM patients. After three months, monthly number of migraine days decreased by 6.4 ± 5.87 (baseline: 13.6 ± 6.5; p < 0.0001) in all patients, 5.2 ± 4.04 in EM and 7.7 ± 7.45 in CM patients. MIDAS scores decreased from 73.3 ± 56.8 (baseline) to 50.3 ± 52.9 (after 3 months; p = 0.0014), HIT-6 scores decreased from 65.9 ± 5.0 to 60.9 ± 7.2 (p < 0.0001). Concomitant use of acute migraine medication had decreased from 9.7 ± 4.98 (baseline) to 4.9 ± 3.66 (3 months) (p < 0.0001). Conclusions Our results show that about 42.8% of anti-CGRP pathway mAb-non-responder benefit from switching to fremanezumab. These results suggest that switching to fremanezumab may be a promising option for patients experiencing poor tolerability or inadequate efficacy with prior other anti-CGRP pathway mAb use. Trial registration Finesse Study is registered on the European Network of Centres for Pharmacoepidemiology and Pharmacovigilance (EUPAS44606). Graphical Abstract

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Section: Introductionmentioning

confidence: 99%

Real-world effectiveness of fremanezumab in patients with migraine switching from another mAb targeting the CGRP pathway: a subgroup analysis of the Finesse Study

et al. 2023

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“…In recent years, with the discovery that migraine attacks may be related to the provocation action of calcitonin gene-related peptide (CGRP) [14], the drugs relating CGRP ligand and receptor have become a new hotspot for clinical use, especially in the acute treatment of migraine attack, and some of them also have been approved for prophylactic treatment one after another, including several CGRP function-blocking monoclonal antibodies (MAbs), erenumab (the recommended dose is 70 mg or 140 mg, two consecutive injections of 70 mg, by subcutaneous injection once a month), fremanezumab (subcutaneous injection once a month or once every 3 months), galcanezumab (the initial loading dose is 240 mg, two consecutive 120 mg, followed by 120 mg per month by subcutaneous injection) and eptinezumab (recommended to be administered 100 mg by intravenous injection every 3 months), etc. [15][16][17][18][19][20]. Although these MAbs have already been available for the prophylactic treatment of migraine, their subcutaneous or intravenous mode of administration caused a degree of inconvenience to patients.…”

Section: Open Accessmentioning

confidence: 99%

The efficacy and safety of atogepant for the prophylactic treatment of migraine: evidence from randomized controlled trials

et al. 2022

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Background Migraine is a common neurovascular disorder that has a severe impact on the individual daily life. Atogepant (AGN-241689) is an orally ingested, small-molecule drugs belonging to calcitonin gene-related peptide receptor antagonist, which has been initiated for the prophylactic treatment of migraine. However, there is no comprehensive literature to study the efficacy and safety of atogepant for the treatment of migraine. In this article, we present a meta-analysis of the available studies. Methods MEDLINE, Embase, Cochrane Library and ClinicalTrials.gov were searched before October 20, 2021 for any relevant literature. Eventually, three randomized clinical trials (RCTs) with 2,466 patients were included in our study. Results We pooled 2,466 patients from 3 RCTs and primary outcome was mean monthly migraine days, the secondary endpoints were monthly headache days, acute medication use days per month and ≥ 50% reduction in monthly migraine days, baseline to end of trials. It was found that atogepant (10 mg, 30 mg, 60 mg once a day) led to a significant reduction in monthly migraine days (P < 0.00001, P < 0.00001, P = 0.007), monthly headache days (P < 0.00001, P < 0.00001, P = 0.001), and monthly medication use days (P < 0.00001, P < 0.00001, P = 0.0001), and an increase in the proportion of people with ≥ 50% reduction in monthly migraine days (P = 0.0008, P = 0.02, P = 0.04) in comparison with placebo. Moreover, there were no significant differences (P > 0.05) in outcomes of adverse events between atogepant and placebo. Conclusions Atogepant has shown good efficacy and safety in the prophylactic treatment of migraine, and further studies are expected.

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Consensus-Based Recommendations on the Use of CGRP-Based Therapies for Migraine Prevention in the UAE

Alsaadi,

Kayed,

Al-Madani

et al. 2023

Neurol Ther

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Galcanezumab for the Prevention of Migraine

Cited by 4 publications

References 55 publications

Real-world effectiveness of fremanezumab in patients with migraine switching from another mAb targeting the CGRP pathway: a subgroup analysis of the Finesse Study

Real-world effectiveness of fremanezumab in patients with migraine switching from another mAb targeting the CGRP pathway: a subgroup analysis of the Finesse Study

The efficacy and safety of atogepant for the prophylactic treatment of migraine: evidence from randomized controlled trials

Consensus-Based Recommendations on the Use of CGRP-Based Therapies for Migraine Prevention in the UAE

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