Recommendations on the Use of Anti‐CGRP Monoclonal Antibodies in Children and Adolescents

Szperka, Christina L.; VanderPluym, Juliana; Orr, Serena L.; Oakley, Christopher; Qubty, William; Patniyot, Irene; Lagman-Bartolome, Ana Marissa; Morris, Cynthia D.; Gautreaux, Jessica; Victorio, M. Cristina; Hagler, Suzanne; Narula, Sona; Candee, Meghan; Cleves-Bayon, Catalina; Rao, Rashmi; Fryer, Robert H.; Bicknese, Alma R.; Yonker, Marcy; Hershey, Andrew D.; Powers, Scott W.; Goadsby, Peter J.; Gelfand, Amy A.

doi:10.1111/head.13414

Cited by 81 publications

(57 citation statements)

References 125 publications

(134 reference statements)

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“…10 Recommendations have been provided by the members of the paediatric and adolescent headache special interest group of the American Headache Society on the clinical use of CGRP monoclonal Early clinical experience with a monoclonal antibody against the calcitonin gene-related peptide receptor in adolescents with migraine: A case series antibodies in children and adolescents. 11 We present here a case series detailing the responses of adolescent patients in the age range 15-18 years to erenumab, highlighting a few cases and providing a summary of the six patients' demographics and responses ( Table 1).…”

Section: Introductionmentioning

confidence: 99%

Early clinical experience with a monoclonal antibody against the calcitonin gene-related peptide receptor in adolescents with migraine: A case series

Zhao

Wong

2020

Proceedings of Singapore Healthcare

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Management of migraine in adolescents poses a great challenge, as many of the approved pharmacological migraine preventive agents have age restrictions. Following favorable safety and efficacy reports of the new class agent calcitonin gene-related peptide (CGRP) monoclonal antibody for use in migraine prevention, there is growing interest in its application in pediatric migraine. We present here a case series detailing our experience of using erenumab, a CGRP monoclonal antibody, in six adolescent patients. Two patients had a reduction of at least 50% in the mean number of monthly migraine days, one patient reported subjective improvement, while three patients did not respond to the first dose of erenumab and discontinued treatment. One patient reported constipation associated with erenumab use. We speculate that CGRP monoclonal antibody could potentially be a viable option in adolescent patients with migraine. Further evidences that support efficacy and safety of erenumab in this group is needed.

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Section: Introductionmentioning

confidence: 99%

Early clinical experience with a monoclonal antibody against the calcitonin gene-related peptide receptor in adolescents with migraine: A case series

Zhao

Wong

2020

Proceedings of Singapore Healthcare

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“…Anti‐calcitonin gene‐related peptide antibodies have recently been developed to use as preventive therapy. Positive effects are seen in early adult studies, but their use in pediatrics is still under study and not readily available …”

Section: Chronic Migrainementioning

confidence: 99%

“…Positive effects are seen in early adult studies, but their use in pediatrics is still under study and not readily available. 42 The best evidence for the therapeutic use of nerve blocks is seen in posttraumatic headaches. A small retrospective study reported on 15 patients who received occipital nerve block for chronic posttraumatic headaches.…”

Section: Treatmentmentioning

confidence: 99%

Episodic and chronic migraine in children

Youssef

Mack

2019

Develop Med Child Neuro

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Migraine is the most common acute and recurrent headache syndrome in children. This condition has unique clinical characteristics in the pediatric population, that can evolve with age, and significantly impact a child's quality of life, affecting their education, socialization, and family life. The purpose of this review is to describe the varied clinical features of migraine seen in children, and discuss potential treatment options for pediatric migraine, including chronic migraine. In many patients a multifaceted approach involving lifestyle changes, treatment of comorbid conditions, and pharmacological treatments are needed for optimal headache control.

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“…The same drugs have been recently approved from European Medicines Agency (Erenumab; Galcanezumab). Although results from trials in children and adolescents are not available yet, the Pediatric and Adolescent Headache special interest group of the American Headache Society proposed recommendations on the use of these agents for pediatric headache disorders (62). The authors suggested that the use of CGRP receptor antagonists could be considered in postpubertal adolescent patients with frequent migraine attacks (≥8 headache days/month), who have moderate to severe disability associated with migraine (PedMIDAS score ≥30) and have failed ≥2 preventive therapies.…”

Section: Further Considerations and Future Prospectivesmentioning

confidence: 99%

“…The authors suggested that the use of CGRP receptor antagonists could be considered in postpubertal adolescent patients with frequent migraine attacks (≥8 headache days/month), who have moderate to severe disability associated with migraine (PedMIDAS score ≥30) and have failed ≥2 preventive therapies. For younger patients, who are refractory to multiple preventive therapies, CGRP receptor antagonists may also be considered with proper monitoring (e.g., bone health, linear growth, weight/BMI, infections) (62).…”

Section: Further Considerations and Future Prospectivesmentioning

confidence: 99%

Prophylactic Treatment of Pediatric Migraine: Is There Anything New in the Last Decade?

et al. 2019

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Migraine is a frequent and very disabling disease, especially at pediatric age. Despite this, there are few controlled data on the prophylactic treatment of primary headaches in this category of age. Given that the recently introduced calcitonin gene-related peptide (CGRP) inhibitors (CGRP-r) are still limited to adulthood, there is no drug with exclusive indication for migraine treatment in pediatric age. This raises several limitations in terms of adherence and effectiveness of the therapy. Moreover, the scenario is complicated by placebo response, which is larger in children and adolescents than in adults and often leads to an improvement in the attack frequency even in absence of any active pharmacological treatment. Our aim was to investigate the real evidence concerning the prophylactic therapy of pediatric migraine by reviewing the clinical studies published between 2010 and 2019.

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Recommendations on the Use of Anti‐CGRP Monoclonal Antibodies in Children and Adolescents

Cited by 81 publications

References 125 publications

Early clinical experience with a monoclonal antibody against the calcitonin gene-related peptide receptor in adolescents with migraine: A case series

Early clinical experience with a monoclonal antibody against the calcitonin gene-related peptide receptor in adolescents with migraine: A case series

Episodic and chronic migraine in children

Prophylactic Treatment of Pediatric Migraine: Is There Anything New in the Last Decade?

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