Hypersensitivity to CGRP as a predictive biomarker of migraine prevention with erenumab
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Hypersensitivity to CGRP as a predictive biomarker of migraine prevention with erenumab. / Al-Khazali, Haidar M.; Ashina, Håkan; Christensen, Rune Häckert; Wiggers, Astrid; Rose, Kathrine; Iljazi, Afrim; Amin, Faisal Mohammad; Ashina, Messoud; Snellman, Josefin; Maio-Twofoot, Tina; Schytz, Henrik W.
I: Cephalalgia : an international journal of headache, Bind 44, Nr. 6, 2024.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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T1 - Hypersensitivity to CGRP as a predictive biomarker of migraine prevention with erenumab
AU - Al-Khazali, Haidar M.
AU - Ashina, Håkan
AU - Christensen, Rune Häckert
AU - Wiggers, Astrid
AU - Rose, Kathrine
AU - Iljazi, Afrim
AU - Amin, Faisal Mohammad
AU - Ashina, Messoud
AU - Snellman, Josefin
AU - Maio-Twofoot, Tina
AU - Schytz, Henrik W.
PY - 2024
Y1 - 2024
N2 - BACKGROUND: The present study aimed to investigate the predictive value of calcitonin gene-related peptide (CGRP)-induced migraine attacks for effectiveness to erenumab treatment in people with migraine. METHODS: In total, 139 participants with migraine underwent a single experimental day involving a 20-min infusion with CGRP. Following this, the participants entered a 24-week treatment period with erenumab. The primary endpoints were the predictive value of CGRP-induced migraine attacks on the effectiveness of erenumab, defined as ≥50% reduction in monthly migraine days, or ≥ 50% reduction in either monthly migraine or monthly headache days of moderate to severe intensity. RESULTS: Among participants with CGRP-induced migraine attacks, 60 of 99 (61%) achieved ≥50% reduction in monthly migraine days during weeks 13-24 with erenumab. Conversely, 13 of 25 (52%) where CGRP infusion did not induce a migraine achieved the same endpoint (p = 0.498). There were no significant differences between the ≥50% reduction in either monthly migraine or monthly headache days of moderate to severe intensity between CGRP-sensitive and non-sensitive participants (p = 0.625). CONCLUSIONS: Our findings suggest that the CGRP-provocation model cannot be used to predict erenumab's effectiveness. It remains uncertain whether this finding extends to other monoclonal antibodies targeting the CGRP ligand or to gepants.Trial Registration: The study was registered at ClinicalTrials.gov (NCT04592952).
AB - BACKGROUND: The present study aimed to investigate the predictive value of calcitonin gene-related peptide (CGRP)-induced migraine attacks for effectiveness to erenumab treatment in people with migraine. METHODS: In total, 139 participants with migraine underwent a single experimental day involving a 20-min infusion with CGRP. Following this, the participants entered a 24-week treatment period with erenumab. The primary endpoints were the predictive value of CGRP-induced migraine attacks on the effectiveness of erenumab, defined as ≥50% reduction in monthly migraine days, or ≥ 50% reduction in either monthly migraine or monthly headache days of moderate to severe intensity. RESULTS: Among participants with CGRP-induced migraine attacks, 60 of 99 (61%) achieved ≥50% reduction in monthly migraine days during weeks 13-24 with erenumab. Conversely, 13 of 25 (52%) where CGRP infusion did not induce a migraine achieved the same endpoint (p = 0.498). There were no significant differences between the ≥50% reduction in either monthly migraine or monthly headache days of moderate to severe intensity between CGRP-sensitive and non-sensitive participants (p = 0.625). CONCLUSIONS: Our findings suggest that the CGRP-provocation model cannot be used to predict erenumab's effectiveness. It remains uncertain whether this finding extends to other monoclonal antibodies targeting the CGRP ligand or to gepants.Trial Registration: The study was registered at ClinicalTrials.gov (NCT04592952).
KW - CGRP hypersensitivity
KW - erenumab
KW - headache disorders
KW - prediction
U2 - 10.1177/03331024241258734
DO - 10.1177/03331024241258734
M3 - Journal article
C2 - 38859744
AN - SCOPUS:85195627881
VL - 44
JO - Cephalalgia
JF - Cephalalgia
SN - 0800-1952
IS - 6
ER -
ID: 395080857