Urinary Proteomics Reveals Promising Biomarkers in Menstrually Related and Post-Menopause Migraine

Patients with high-frequency resistant migraine and medication-overuse headache are still the main clinical challenge in tertiary headache centers. The approval of targeted antibodies against the calcitonin gene-related peptide (CGRP) and its receptor represents a powerful instrument. In this study, we observed how biological and clinical features of resistant migraineurs responded to erenumab, fremanezumab, or galcanezumab. We found a reduction in advanced oxidation protein products (AOPP) as a biomarker of improved redox state after six months of treatment. We also found that treatment efficacy was precocious and maintained with high individual responder rates. In particular, seven out of ten patients achieved a reduction of 50% from the baseline at three months, which was maintained at six months, while about one out of our patients experienced a 75% reduction in headache frequency from the first month of treatment. The migraine disability assessment (MIDAS) and the associated fatigue, anxiety, and sleep quality also significantly improved. The allodynia symptom dropped from moderate/severe to mild/absent as a sign of central sensitization reduction. Our study confirmed the safety and efficacy of CGRP inhibition in real-life, high-challenging patients. Additional evidence is needed to understand the role of oxidative stress as a migraine biomarker.

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“…A novel biomarker could both shed some light on the migraine pathophysiology and lead towards precision-medicine targets [ 8 , 9 , 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

CGRP Inhibitors and Oxidative Stress Biomarkers in Resistant Migraine: A Real-Life Study with Erenumab, Fremanezumab, and Galcanezumab

Luca

Baldacci

Mazzucchi

et al. 2021

JCM

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“…The presence of these experimental cohorts makes it difficult to deal with other categories of patients also experiencing similar clinical syndromes. It could be important to focus on the elderly, understanding the prevalence of the disease, clinical differences, response to treatment, and social factors, or on how the same disease could vary considering hormonal changes in young and post-menopause women [ 13 , 14 ]. In particular, the presence of quantifiable proteins from accessible body fluids such as urine could lead to a specific understanding of the atypical presentation of primary headache in the elderly.…”

mentioning

confidence: 99%