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000165134 0247_ $$2doi$$a10.3390/toxins14080529
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000165134 037__ $$aDZNE-2022-01439
000165134 041__ $$aEnglish
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000165134 1001_ $$00000-0001-5846-7058$$aScuteri, Damiana$$b0
000165134 245__ $$aPooled Analysis of Real-World Evidence Supports Anti-CGRP mAbs and OnabotulinumtoxinA Combined Trial in Chronic Migraine.
000165134 260__ $$aBasel$$bMDPI$$c2022
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000165134 520__ $$aOnabotulinumtoxinA, 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.
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000165134 650_7 $$2Other$$aPRISMA 2020
000165134 650_7 $$2Other$$aanti-CGRP monoclonal antibodies
000165134 650_7 $$2Other$$amigraine
000165134 650_7 $$2Other$$aonabotulinumtoxinA
000165134 650_7 $$2Other$$apooled analysis
000165134 650_7 $$2NLM Chemicals$$aAntibodies, Monoclonal
000165134 650_7 $$0EC 3.4.24.69$$2NLM Chemicals$$aBotulinum Toxins, Type A
000165134 650_7 $$0JHB2QIZ69Z$$2NLM Chemicals$$aCalcitonin Gene-Related Peptide
000165134 650_2 $$2MeSH$$aAntibodies, Monoclonal: therapeutic use
000165134 650_2 $$2MeSH$$aBotulinum Toxins, Type A: therapeutic use
000165134 650_2 $$2MeSH$$aCalcitonin Gene-Related Peptide: antagonists & inhibitors
000165134 650_2 $$2MeSH$$aDrug Therapy, Combination: adverse effects
000165134 650_2 $$2MeSH$$aHumans
000165134 650_2 $$2MeSH$$aMigraine Disorders: prevention & control
000165134 650_2 $$2MeSH$$aTreatment Outcome
000165134 7001_ $$00000-0002-4867-1378$$aTonin, Paolo$$b1
000165134 7001_ $$0P:(DE-2719)2010732$$aNicotera, Pierluigi$$b2$$udzne
000165134 7001_ $$aVulnera, Marilù$$b3
000165134 7001_ $$aAltieri, Giuseppina Cristina$$b4
000165134 7001_ $$aTarsitano, Assunta$$b5
000165134 7001_ $$00000-0001-8540-6218$$aBagetta, Giacinto$$b6
000165134 7001_ $$00000-0001-6472-0697$$aCorasaniti, Maria Tiziana$$b7
000165134 770__ $$aBotulinum Neurotoxin: Shared/Common Mechanisms in the Treatment of Pain, Spasticity and Movement Disorders
000165134 773__ $$0PERI:(DE-600)2518395-3$$a10.3390/toxins14080529$$gVol. 14, no. 8, p. 529 -$$n8$$p529$$tToxins$$v14$$x2072-6651$$y2022
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