2023
DOI: 10.1177/03331024221150235
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Preventive CGRP-targeted therapies for chronic migraine with and without medication-overuse headache

Abstract: Background: Calcitonin gene-related peptide (CGRP) targeted therapies are an important breakthrough in migraine prevention. Randomized clinical trials, post-hoc analyses, and phase IV studies have demonstrated their efficacy and safety in chronic migraine patients, including those with concomitant medication-overuse and medication-overuse headache. Real world evidence studies support these findings and provide realistic endpoints for estimation of effect. Methods and results We have performed a narrative revie… Show more

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Cited by 9 publications
(3 citation statements)
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References 81 publications
(120 reference statements)
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“…Excessive use of acute medications is, together with high attack frequency and depression [ 30 ], the most important risk factor for migraine chronification and associated with so-called medication overuse headache (MOH) (ICHD-3 8.2). In RCTs where CM patients with medication overuse were subanalyzed, efficacy of all 4 anti-CGRP/rec mAbs was comparable to that found in patients without such overuse [ 31 , 32 ]. This was also the case in most real-world studies [ 15 ], although in some studies outcome was less favorable in patients with MOH [ 33 36 ].…”
Section: Is Their Efficacy Identical In All Migraine Subtypes?mentioning
confidence: 98%
“…Excessive use of acute medications is, together with high attack frequency and depression [ 30 ], the most important risk factor for migraine chronification and associated with so-called medication overuse headache (MOH) (ICHD-3 8.2). In RCTs where CM patients with medication overuse were subanalyzed, efficacy of all 4 anti-CGRP/rec mAbs was comparable to that found in patients without such overuse [ 31 , 32 ]. This was also the case in most real-world studies [ 15 ], although in some studies outcome was less favorable in patients with MOH [ 33 36 ].…”
Section: Is Their Efficacy Identical In All Migraine Subtypes?mentioning
confidence: 98%
“…In patients with long-lasting abuse of opioids, barbiturates or tranquilizers, slow tapering of these drugs is recommended (4). Currently, there is debate whether adding novel preventive medication such as calcitonin gene-related peptide (CGRP)-blockers might be useful to ensure that patients are successful at drug withdrawal (39). Behavioural intervention by a headache nurse during withdrawal therapy for MOH has been demonstrated to be beneficial in a recent concealed double-blind randomized controlled trial (37).…”
Section: Discussionmentioning
confidence: 99%
“…The International Headache Society deems, therefore, that the composition of the author groups will provide a presentation of the efficacy and potential side effects or safety aspects of the new drugs for the treatment of acute migraine attacks and for the prevention of migraine that is as objective as possible and can be used for clinical practice. In addition to meta-analyses of efficacy and tolerability or safety for both acute and preventive medications (13), some of the publications address practical aspects of use, such as migraine prevention in patients with medication overuse or medication overuse headache (4), the results of open-label long-term studies for both drugs for acute therapy (5) and for migraine prophylaxis (6), and other aspects such as nonresponders to previous therapies, combination therapy switching, and termination of therapy (7,8).…”
Section: New Drugs For the Acute Treatment Of Migraine Attacks And Fo...mentioning
confidence: 99%