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Potential Predictors of Response to CGRP Monoclonal Antibodies in Chronic Migraine: Real-World Data

  • Chronic Daily Headache (S-J Wang and S-P Chen, Section Editors)
  • Published:
Current Pain and Headache Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Real-world data (RWD) has identified potential predictors of response to anti-CGRP therapies in patients with chronic migraine (CM). This review aims to synthesize the most remarkable findings published to date regarding this topic.

Recent Findings

Migraine features such as unilateral pain and positive triptan response and chronic features such as daily headache or medication overuse (MO) emerge as predictors of positive outcomes, potentially linked to elevated baseline serum anti-calcitonin gene-related peptide (anti-CGRP) levels. Demographic and baseline characteristics, encompassing obesity, psychiatric comorbidities, and prior refractoriness to prophylactic treatments, are associated with poor responses in both treatment-naïve patients and after-switch scenarios. Nevertheless, the consistency of these predictors across diverse populations requires further investigation.

Summary

Recent RWD literature highlights emerging predictors of response of different sources among patients with CM receiving anti-CGRP therapies. Comprehending these predictors and identifying novel biomarkers of response hold the potential to refine treatment strategies for CM patients, enhancing their management and therapeutic outcomes.

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Data Availability

Data is available upon reasonable request.

Abbreviations

CM:

Chronic migraine

EM:

Episodic migraine

BMI:

Body mass index

MHD:

Monthly headache days

MMD:

Monthly migraine days

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Funding

This research received funding from Instituto de Salud Carlos III (ISCIII) and the European Union (ESF +) through a Río Hortega Fellowship (CM21/00178) to A.G.M and through PMP project (PMP22/00158) to A.G.M, A.B.G.V., D.G.A., A.L.G. P.

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Authors and Affiliations

  1. Headache Unit, Hospital Universitario de la Princesa & Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Diego de León 62, 28006, Madrid, Spain

    Carmen Sánchez-Rodríguez, Ana Beatriz Gago-Veiga & Alicia Gonzalez-Martinez

  2. Headache Unit, Hospital Clínico Universitario de Valladolid & Department of Medicine, University of Valladolid, Valladolid, Spain

    David García-Azorín & Ángel Luis Guerrero-Peral

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  1. Carmen Sánchez-Rodríguez
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  2. Ana Beatriz Gago-Veiga
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  3. David García-Azorín
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  4. Ángel Luis Guerrero-Peral
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Contributions

Carmen Sánchez-Rodríguez (CSR), Ana Beatriz Gago-Veiga (ABGV), David García-Azorín (DGA), Ángel Luis Guerrero-Peral (ALGP), Alicia Gonzalez-Martinez (AGM). Category 1: a. Conceptualization and design: CSR, AGM; b. Acquisition of data: CSR, AGM; c. Analysis and interpretation of data: CSR, ABGV, DGA, ALGP, AGM. Category 2: a. Drafting the manuscript: CSR, AGM; b. Revising it for intellectual content: CSR, ABGV, DGA, ALGP, AGM. Category 3: Final approval of the completed manuscript: CSR, ABGV, DGA, ALGP, AGM.

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Correspondence to Alicia Gonzalez-Martinez.

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Conflict of Interest

Carmen Sánchez-Rodríguez has no relevant financial or non-financial interests to disclose. Ana Beatriz Gago-Veiga has received honoraria from Lilly, Novartis, TEVA, Abbvie-Allergan, Exeltis, and Chiesi. David García-Azorín reports payment or honoraria for lectures from Teva, Lilly, Allergan-Abbvie, Novartis, and Lundbeck and has served on an advisory board for Allergan-Abbvie. Ángel Luis Guerrero-Peral has received honoraria from Lilly, TEVA, Novartis, Allergan-Abbvie, and Exeltis and research support from Allegan-Abbvie and TEVA. Alicia Gonzalez-Martinez has received speaker honoraria from TEVA.

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Sánchez-Rodríguez, C., Gago-Veiga, A.B., García-Azorín, D. et al. Potential Predictors of Response to CGRP Monoclonal Antibodies in Chronic Migraine: Real-World Data. Curr Pain Headache Rep (2023). https://doi.org/10.1007/s11916-023-01183-6

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