Prophylaxis of migraines with monoclonal antibodies against CGRP or the CGRP receptor, addendum to the S1 guideline treatment of migraine attacks and prevention of migraine

Diener, Hans‐Christoph; Förderreuther, Stefanie; Gaul, Charly; Giese, Florian; Hamann, Till; Holle-Lee, Dagny; Jürgens, Tim P.; Kamm, Katharina; Kraya, Torsten; Lampl, Christian; May, Arne; Reuter, Uwe; Scheffler, Armin; Tfelt‐Hansen, Peer

doi:10.1007/s42451-020-00163-z

Cited by 24 publications

(21 citation statements)

References 12 publications

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“…Am häufigsten sind Lokalreaktionen, Obstipation, Überempfindlichkeitsreaktionen und Muskelschmerzen. Die Gegenanzeigen und Warnhinweise aus der Leitlinie finden sich im Kasten [13]. Eine Kontraindikation besteht für Schwangerschaft und Stillzeit, was wegen der jungen Patientenklientel relevant ist.…”

Section: Verträglichkeit Und Sicherheitunclassified

“…Leitlinie der Deutschen Gesellschaft für Neurologie [13] ▪ "Nicht einsetzen": Schwangerschaft, Stillzeit, keine ausreichende Kontrazeption ▪ "Vorsichtshalber nicht": Koronare Herzkrankheit, ischämischer Insult, Subarachnoidalblutung, periphere arterielle Verschlusskrankheit ▪ "Keine Informationen zu Verträglichkeit und Sicherheit":…”

Section: Gegenanzeigen Und Warnhinweiseunclassified

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Neues in der Migränetherapie

Ruscheweyh

Hoffmann

2021

Nervenheilkunde

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ZUSAMMENFASSUNGMigränepatienten brauchen eine wirksame Akuttherapie und in schwereren Fällen auch eine medikamentöse Prophylaxe. In den letzten Jahren sind erstmals gezielt in die Pathophysiologie der Migräne eingreifende Substanzen entwickelt worden, die über die Blockade von CGRP wirken. Dies sind einerseits die Antikörper gegen CGRP und den CGRP-Rezeptor, die prophylaktisch wirken, andererseits die Gepante (CGRP-Rezeptorantagonisten), die sowohl in der Akuttherapie als auch in der Prophylaxe der Migräne eingesetzt werden können. Gemeinsam ist diesen Substanzen ihre gute Verträglichkeit. CGRP-(Rezeptor)-Antikörper haben gegenüber klassischen Prophylaktika den Vorteil eines schnellen Wirkeintritts. Für die Gepante in der Akuttherapie weisen tierexperimentelle Daten darauf hin, dass sie anders als Triptane eventuell nicht zu einem Kopfschmerz bei Medikamentenübergebrauch führen.

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Section: Verträglichkeit Und Sicherheitunclassified

Section: Gegenanzeigen Und Warnhinweiseunclassified

Neues in der Migränetherapie

Ruscheweyh

Hoffmann

2021

Nervenheilkunde

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“…Those substances are beta-blockers, flunarizine, topiramate, valproic acid, and amitriptyline. 17 In this study, we assessed the value of prophylactic treatment with CGRP inhibitors in terms of reduced migraine days and avoided productivity losses compared with increased healthcare costs when all eligible patients received CGRP inhibitors independent of previous treatment failures. Avoided productivity losses were estimated using the social impact approach recently published by Himmler et al 18 and data from the erenumab clinical trials.…”

Section: Introductionmentioning

confidence: 99%

Social Impact of Prophylactic Migraine Treatments in Germany: A State-Transition and Open Cohort Approach

et al. 2021

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Objectives: Migraine is a highly prevalent neurological disorder. The most characteristic symptom of migraine is moderate to severe recurrent headache along with other neurological symptoms. In this study, we modeled the potential reduction in migraine days and corresponding avoided productivity losses if erenumab was prescribed to the patient population indicated for prophylactic migraine treatment ($ 4 monthly migraine days [MMDs]) in Germany from 2020 to the end of 2027.Methods: We simulated the incremental benefits of erenumab against the standard of care. Response rates, transition probabilities, discontinuation rates, and productivity estimates were derived from the erenumab clinical trial program. Patients had a probability of residing in 1 of 7 states, given the MMDs in addition to the probability of death. Based on accrued MMDs in every cycle, days of absenteeism and presenteeism for paid and unpaid work were derived. Paid work was monetized according to gross value added using the human capital approach, whereas unpaid work was valuated according to the proxy good method. In addition, downstream macroeconomic effects were captured using value-added multipliers. Direct medical costs were concomitantly calculated.Results: Our results show that prescribing erenumab for the indicated population in Germany could lead to a reduction of 166 million migraine days annually and reduce productivity losses in the range of V27 billion. This includes V13.1 billion from direct productivity and V13.5 billion from economic value chain effects.Conclusions: This study highlights the macroeconomic effects of a systematic introduction of novel inhibitors of the calcitonin gene-related peptide pathway for migraine in Germany.

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“…This guideline is an abridged and translated version of the guideline published by Diener H-C, May A et al, Prevention of migraine with monoclonal antibodies against CGRP or the CGRP receptor, Supplement to S1 Guideline Therapy of Migraine Attack and Prevention of Migraine, 2019, Deutsche Gesellschaft für Neurologie (eds. ), Guidelines for Diagnostics and Therapy in Neurology [ 1 ]. A complete version of this guideline can be found on the website of the Deutsche Gesellschaft für Neurologie ( www.dgn.org/leitlinien ) and the AWMF (Arbeitsgemeinschaft wissenschaftlicher Medizinischer Gesellschaften).…”

Section: Introductionmentioning

confidence: 99%

“…Patients with frequent or severe migraine attacks require non-drug and/or drug migraine prevention in addition to effective treatment of the acute migraine attack [ 1 ]. Until now, according to the Guidelines of the German Society of Neurology and the German Migraine and Headache Society, the beta-receptor blockers propranolol, metoprolol and bisoprolol, the calcium antagonist flunarizine, the anticonvulsants valproic acid and topiramate as well as the tricyclic antidepressant amitriptyline have been available for this purpose with a high degree of evidence [ 1 ]. According to a decision of the German Federal Joint Committee, specialists in neurology or psychiatry ( https://www.g-ba.de/downloads/39-261-3911/2019-08-06_AM-RL-VI-SN_Valproinsäure-Migräneprophylaxe.pdf ) may prescribe valproic acid for the treatment of migraine.…”

Section: Introductionmentioning

confidence: 99%

Prevention of migraine with monoclonal antibodies against CGRP or the CGRP receptor

Diener

Förderreuther

Gaul

et al. 2020

Neurol. Res. Pract.

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Monoclonal antibodies against the calcitonin gene-related peptide (CGRP) receptor (Erenumab) or against CGRP (Eptinezumab, Fremanezumab, Galcanezumab) are new substances for the preventive treatment of migraine. They represent an extension of the therapeutic options, which already exist in migraine prevention. In randomized, placebo-controlled studies, the efficacy and good tolerability of these specific substances have been demonstrated in patients with episodic and chronic migraine. The following treatment recommendation presents a summary of the pivotal studies. Recommendations are provided for the targeted selection of patients as well as for the evaluation of therapeutic success and the duration of treatment. Finally, possible restrictions on the use of this new substance group are discussed. This guideline is an abridged and translated version of the guideline published by Diener H-C, May A et al., Prevention of migraine with monoclonal antibodies against CGRP or the CGRP receptor, Supplement to S1 Guideline Therapy of Migraine Attack and Prevention of Migraine, 2019, Deutsche Gesellschaft für Neurologie (eds.), Guidelines for Diagnostics and Therapy in Neurology. A complete version of this guideline can be found on the website of the Deutsche Gesellschaft für Neurologie (www.dgn.org/leitlinien) and the AWMF (Arbeitsgemeinschaft wissenschaftlicher Medizinischer Gesellschaften). This guideline has been approved by the German Neurological Society (DGN) and the German Migraine and Headache Society (GMHS) and was reviewed by the two societies.

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Prophylaxis of migraines with monoclonal antibodies against CGRP or the CGRP receptor, addendum to the S1 guideline treatment of migraine attacks and prevention of migraine

Cited by 24 publications

References 12 publications

Neues in der Migränetherapie

Neues in der Migränetherapie

Social Impact of Prophylactic Migraine Treatments in Germany: A State-Transition and Open Cohort Approach

Prevention of migraine with monoclonal antibodies against CGRP or the CGRP receptor

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