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Calcitonin gene-related peptide monoclonal antibodies for migraine prevention: comparisons across randomized controlled studies.
Curr Opin Neurol. 2017 06; 30(3):272-280.CO

Abstract

PURPOSE OF REVIEW

The results of phase 2 randomized controlled trials for the prevention of episodic and chronic migraine demonstrating the efficacy and safety of four mAbs targeting the calcitonin gene-related peptide (CGRP) pathway [ALD403 (eptinezumab), AMG334 (erenumab), LY2951742 (galcanezumab) and TEV48125 (fremanezumab)] have been published recently, and phase 3 trials are in process. This development will change headache management fundamentally. We aim to summarize and compare the phase 2 data.

RECENT FINDINGS

The change from baseline in the number of migraine days at the end of treatment in high-frequency episodic migraine was -1 (at weeks 5-8), -1.1 (at weeks 9-12), -1.2 (at weeks 9-12) and -2.6 (at weeks 9-12) days for ALD403, AMG344, LY2951742 and TEV48125 (225 mg), respectively. Number needed to treats for responders and odds ratio for any adverse event were 4.7, 6.2, 4.0 and 4.0 and 1.09, 0.96, 1.07 and 1.05, respectively.

SUMMARY

All four CGRP antibodies display comparable efficacy that does not differ significantly from that of the currently available oral antimigraine drugs. However, their safety and tolerability profiles as well as low frequency of administration looks promising but remains to be verified in long-term and large-scale trials. Considerations related to pregnancy, risk for cardiovascular effects and cost are subject for further evaluation.

Authors+Show Affiliations

a1st Neurology Department, Aeginition Hospital, National & Kapodistrian University of Athens, Athens, Greece bDepartment of Neurology, Charité Universitätsmedizin Berlin, Berlin, Germany.No affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

28240610

Citation

Mitsikostas, Dimos D., and Uwe Reuter. "Calcitonin Gene-related Peptide Monoclonal Antibodies for Migraine Prevention: Comparisons Across Randomized Controlled Studies." Current Opinion in Neurology, vol. 30, no. 3, 2017, pp. 272-280.
Mitsikostas DD, Reuter U. Calcitonin gene-related peptide monoclonal antibodies for migraine prevention: comparisons across randomized controlled studies. Curr Opin Neurol. 2017;30(3):272-280.
Mitsikostas, D. D., & Reuter, U. (2017). Calcitonin gene-related peptide monoclonal antibodies for migraine prevention: comparisons across randomized controlled studies. Current Opinion in Neurology, 30(3), 272-280. https://doi.org/10.1097/WCO.0000000000000438
Mitsikostas DD, Reuter U. Calcitonin Gene-related Peptide Monoclonal Antibodies for Migraine Prevention: Comparisons Across Randomized Controlled Studies. Curr Opin Neurol. 2017;30(3):272-280. PubMed PMID: 28240610.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Calcitonin gene-related peptide monoclonal antibodies for migraine prevention: comparisons across randomized controlled studies. AU - Mitsikostas,Dimos D, AU - Reuter,Uwe, PY - 2017/2/28/pubmed PY - 2018/1/13/medline PY - 2017/2/28/entrez SP - 272 EP - 280 JF - Current opinion in neurology JO - Curr Opin Neurol VL - 30 IS - 3 N2 - PURPOSE OF REVIEW: The results of phase 2 randomized controlled trials for the prevention of episodic and chronic migraine demonstrating the efficacy and safety of four mAbs targeting the calcitonin gene-related peptide (CGRP) pathway [ALD403 (eptinezumab), AMG334 (erenumab), LY2951742 (galcanezumab) and TEV48125 (fremanezumab)] have been published recently, and phase 3 trials are in process. This development will change headache management fundamentally. We aim to summarize and compare the phase 2 data. RECENT FINDINGS: The change from baseline in the number of migraine days at the end of treatment in high-frequency episodic migraine was -1 (at weeks 5-8), -1.1 (at weeks 9-12), -1.2 (at weeks 9-12) and -2.6 (at weeks 9-12) days for ALD403, AMG344, LY2951742 and TEV48125 (225 mg), respectively. Number needed to treats for responders and odds ratio for any adverse event were 4.7, 6.2, 4.0 and 4.0 and 1.09, 0.96, 1.07 and 1.05, respectively. SUMMARY: All four CGRP antibodies display comparable efficacy that does not differ significantly from that of the currently available oral antimigraine drugs. However, their safety and tolerability profiles as well as low frequency of administration looks promising but remains to be verified in long-term and large-scale trials. Considerations related to pregnancy, risk for cardiovascular effects and cost are subject for further evaluation. SN - 1473-6551 UR - https://www.unboundmedicine.com/medline/citation/28240610/Calcitonin_gene_related_peptide_monoclonal_antibodies_for_migraine_prevention:_comparisons_across_randomized_controlled_studies_ L2 - https://doi.org/10.1097/WCO.0000000000000438 DB - PRIME DP - Unbound Medicine ER -