Journal Article

DZNE-2022-01439

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Pooled Analysis of Real-World Evidence Supports Anti-CGRP mAbs and OnabotulinumtoxinA Combined Trial in Chronic Migraine.

Scuteri, D. ; Tonin, P. ; Nicotera, P.DZNE* ; Vulnera, M. ; Altieri, G. C. ; Tarsitano, A. ; Bagetta, G. ; Corasaniti, M. T.

2022
MDPI Basel

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Please use a persistent id in citations: doi:10.3390/toxins14080529

Abstract: OnabotulinumtoxinA, targeting the CGRP machinery, has been approved for the last two decades for chronic migraine prevention. The recently approved monoclonal antibodies (mAbs) directed towards the calcitonin gene-related peptide (CGRP) pathway open a new age for chronic migraine control. However, some 40% patients suffering from chronic migraine is still resistant to treatment. The aim of this work is to answer the following PICOS (participants intervention comparator outcome study design) question: Is there evidence of efficacy and safety of the combined administration of anti-CGRP mAbs and onabotulinumtoxinA in chronic migraine? A systematic review and meta-analysis [Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 recommendations] was made up to 19 April 2022. The results are encouraging: the combined treatment proved to afford ≥50% monthly headache days (MHDs)/frequency reduction respect to baseline in up to 58.8% of patients; in comparison, anti-CGRP mAbs reduce MHDs of 1.94 days from baseline and botulinum toxin of 1.86 days. Our study demonstrates for the first time that the combination therapy of onabotulinumtoxinA with anti-CGRP mAbs affords a reduction of 2.67 MHDs with respect to onabotulinumtoxinA alone, with moderate certainty of evidence. Adequately powered, good-quality studies are needed to confirm the response to combination therapy in terms of efficacy and safety. PROSPERO registration: CRD42022313640.

Keyword(s): Antibodies, Monoclonal: therapeutic use (MeSH) ; Botulinum Toxins, Type A: therapeutic use (MeSH) ; Calcitonin Gene-Related Peptide: antagonists & inhibitors (MeSH) ; Drug Therapy, Combination: adverse effects (MeSH) ; Humans (MeSH) ; Migraine Disorders: prevention & control (MeSH) ; Treatment Outcome (MeSH) ; PRISMA 2020 ; anti-CGRP monoclonal antibodies ; migraine ; onabotulinumtoxinA ; pooled analysis ; Antibodies, Monoclonal ; Botulinum Toxins, Type A ; Calcitonin Gene-Related Peptide

Note: CC BY: https://creativecommons.org/licenses/by/4.0/

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Contributing Institute(s):

1. Scientific board (Scientific board)
2. Aging and neurodegeneration (AG Bano)

Research Program(s):

1. 351 - Brain Function (POF4-351) (POF4-351)

Appears in the scientific report 2022

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