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Letter
Switching of anti-migraine antibodies: effectiveness or regression to the mean?
  1. Emilio Jesus Alegre-Del Rey,
  2. Silvia Fénix-Caballero,
  3. Carmen María Domínguez-Santana
  1. Pharmacy, Hospital Universitario Puerto Real, Puerto Real, Cádiz, Spain
  1. Correspondence to Emilio Jesus Alegre-Del Rey, Pharmacy, Hospital Universitario de Puerto Real, Puerto Real, Cádiz 11510, Spain; emilioj.alegre.sspa{at}juntadeandalucia.es

https://doi.org/10.1136/ejhpharm-2024-004102

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    The efficacy of anti-calcitonin gene-related peptide (CGRP) antibodies is limited. In the pivotal trial of erenumab, a response rate of 41.2% (47/187) was observed, defined as at least a 50% reduction in the number of migraine days per month. In comparison, the response rate for the placebo group was 23.5% (63/281), resulting in a difference of 17.7% and a number needed to treat of six, indicating that only one out of six patients will respond.1 The treatment is quickly recognised as ineffective in the majority of patients, raising questions about antibody switching. One point to consider is that erenumab is directed against the receptor while others are directed against the ligand.

    Talbot et al …

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    Footnotes

    • Twitter @EmilioAlegre1

    • Contributors EJA-R, CMD-S and SF-C planned the letter and its design. EJA-R wrote the original draft and drew the figure. CMD-S and SF-C discussed the draft and made significant contributions. EJA-R, CMD-S and SF-C approved the final text.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; internally peer reviewed.