Background and Importance Migraine is a highly disabling neurovascular disorder characterised by a severe headache and trigeminovascular system activation, involving the release of calcitonin-gene related peptide (CGRP). Galcanezumab is a humanised monoclonal antibody blocking the CGRP.
The effectiveness of galcanezumab in the prophylaxis of chronic migraine
Response to other anti-CGRP monoclonal antibodies after galcanezumab failure
Material and Methods Observational-retrospective study from January 2020 to September 2022. Patients in whom at least one year had passed since the start of galcanezumab treatment were included.
Variables analysed: demographics, baseline migraine days/month (MDM), three months later, objective response rate (ORR) >50%, duration, reason for suspension, and action. The headache impact test (HIT-6) was performed at baseline vs after three months of treatment. This score presents a range between 36 and 78 (<49= little or no impact, 50-55= certain impact, 56-59= important impact, >60= very severe impact).
Quantitative variables were expressed as median (interquartile range).
Results 56 patients were included.
- 9%(5) of the patients continue with active treatment, 100% maintain effectiveness, median MDM: 3(2-6).
- 91% (51) discontinued treatment:
Conclusion and Relevance A high percentage of patients presented a good response to galcanezumab, with an improvement in the HIT-6 score.
A large number of patients who received temporary prophylaxis with galcanezumab did not require another visit to the neurologist. Most of the patients who required reintroduction of galcanezumab reached an ORR>50%.
Less than half of the patients who restarted therapy with a different anti-CGRP after galcanezumab failure, achieved an ORR>50%.
All patients who continued with galcanezumab from the start, maintained effectiveness of the treatment
Conflict of Interest No conflict of interest
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