2021
DOI: 10.21203/rs.3.rs-786742/v1
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Psychological Predictors of Negative Treatment Outcome with Erenumab in Chronic Migraine: Data From an Open Label Long-Term Prospective Study

Abstract: BackgroundMonoclonal antibodies (mABs) targeting the calcitonin gene-related peptide (CGRP) pathway represent the first disease-specific preventive migraine therapy. A wealth of evidence has shown that they are effective in the preventive treatment of difficult-to-treat patients. In this study, we evaluated the psychological predictors of the outcome of treatment with the anti-CGRP monoclonal antibody erenumab in patients with chronic migraine (CM).MethodsSeventy-five patients with CM who had already failed at… Show more

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Cited by 2 publications
(3 citation statements)
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“…A possible reason for this is the presence of specific psychological traits that, even in the absence of major psychiatric diseases, contribute to a vicious cycle where maladaptive behavior and migraine feed off each other [26]. This is in line with recent data suggesting that, although monoclonal antibodies targeting calcitonin gene-related peptide (CGRP) pathway are usually effective in difficult-to-treat patients, the presence of "anxious-fearful" personality together with current stressors and anxiety represent negative predictors of treatment outcome [27]. All these observations suggest that a purely biomedical model of migraine is not fully appropriate to understand the various aspects of the disease and to improve the quality of life of patients.…”
Section: Discussionsupporting
confidence: 74%
“…A possible reason for this is the presence of specific psychological traits that, even in the absence of major psychiatric diseases, contribute to a vicious cycle where maladaptive behavior and migraine feed off each other [26]. This is in line with recent data suggesting that, although monoclonal antibodies targeting calcitonin gene-related peptide (CGRP) pathway are usually effective in difficult-to-treat patients, the presence of "anxious-fearful" personality together with current stressors and anxiety represent negative predictors of treatment outcome [27]. All these observations suggest that a purely biomedical model of migraine is not fully appropriate to understand the various aspects of the disease and to improve the quality of life of patients.…”
Section: Discussionsupporting
confidence: 74%
“…Also higher basal headache frequency was associated to a better erenumab response in CM [9]. At variance, psychological and psychiatric comorbidities as well as previously failed preventive therapies seem to play an important role as negative predictors of outcome [7][8][9][10][34][35][36][37][38]. No concordance was found on gender and erenumab responsiveness in CM, as both an association to male sex and no difference among gender were detected [10,40].…”
Section: Discussionmentioning
confidence: 94%
“…CGRP-mAbs' efficacy and safety have been largely documented in multiple randomized and open-label studies [5,6]. Effectiveness and good tolerability has also been supported in the realworld setting [7][8][9][10].…”
Section: Introductionmentioning
confidence: 99%