Efficacy of monoclonal antibodies against CGRP in migraine patients with fibromyalgia comorbidity: a retrospective monocentric observational study.

IF 7.3 1区 医学 Q1 CLINICAL NEUROLOGY
Marina de Tommaso, Stefania Scannicchio, Giulia Paparella, Livio Clemente, Giuseppe Libro
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引用次数: 0

Abstract

Background: Migraine is a common comorbidity with fibromyalgia (FM). CGRP is a potent inflammatory neuropeptide that may play a role in somatic and visceral pain either inflammatory or neuropathic. Previous studies have reported a significant number of migraine patients with FM responding to anti-CGRP therapies. The potential impact on diffuse pain and global disability associated with fibromyalgia is still unclear. In this retrospective, observational, cross-sectional study, we aimed to analyze the effects of a monoclonal antibody therapy in a subpopulation of migraineurs with FM compared to patients without this comorbidity by assessing the headache frequency and disability as well as the severity of FM (assessed by the Fibromyalgia Impact Questionnaire (FIQ).

Methods: Among 1088 patients came for the first visit to our headache Center between January 1, 2021, and December 31, 2022, we examined six-month outcomes of 148 migraine patients prescribed various monoclonal antibodies to CGRP, erenumab, galcanezumab, and fremanezumab. One hundred and twenty-two patients were selected, 26 of whom suffered from FM. We retrospectively evaluated the following characteristics at baseline (T0) and after 6 months (T1),headache frequency and severity, number of days with symptomatic medication, and MIDAS score. In the FM patients, we evaluated the FIQ and the intensity of somatic pain using a numerical rating scale from 0 to 10.

Results: Headache characteristics improved similarly in patients with and without FM comorbidity. The number of patients in whom headache frequency decreased by at least 50% was similar in the two migraine groups. In patients with FM, both fibromyalgia-related disability and somatic pain improved. The improvement in fibromyalgia disability was significantly correlated with the improvement in migraine-related disability.

Conclusions: We found that in migraine suffereres with FM, anti-CGRP monoclonal antibodies had a similar beneficial effect on migraine as in non-fibromyalgia patients, in addition to reducing somatic pain and global disability from the disease. The anti-CGRP agents, represent a good option for the treatment of migraineurs with fibromyalgia, for which no resolutive therapy is yet available.

抗CGRP单克隆抗体对合并纤维肌痛的偏头痛患者的疗效:一项回顾性单中心观察研究
背景:偏头痛是纤维肌痛(FM)的常见合并症。CGRP是一种有效的炎性神经肽,可能在炎性或神经性躯体和内脏疼痛中发挥作用。先前的研究报道了大量偏头痛患者对抗cgrp治疗有反应。纤维肌痛对弥漫性疼痛和全身残疾的潜在影响尚不清楚。在这项回顾性、观察性、横断面研究中,我们旨在通过评估头痛频率、残疾以及FM的严重程度(通过纤维肌痛影响问卷(FIQ)评估),分析单克隆抗体治疗对偏头痛伴FM患者亚群的影响,并与没有这种合并症的患者进行比较。方法:在2021年1月1日至2022年12月31日期间首次来我们头痛中心就诊的1088名患者中,我们检查了148名偏头痛患者的六个月结局,这些患者服用了CGRP、erenumab、galcanezumab和fremanezumab的各种单克隆抗体。选取122例患者,其中26例为FM患者。我们回顾性地评估了基线(T0)和6个月后(T1)的以下特征,头痛频率和严重程度,对症药物治疗的天数以及MIDAS评分。在FM患者中,我们使用从0到10的数值评分量表评估FIQ和躯体疼痛强度。结果:头痛特征在有和没有FM合并症的患者中改善相似。在两组偏头痛患者中,头痛频率减少至少50%的患者人数相似。在FM患者中,纤维肌痛相关残疾和躯体疼痛均得到改善。纤维肌痛残疾的改善与偏头痛相关残疾的改善显著相关。结论:我们发现,在FM偏头痛患者中,抗cgrp单克隆抗体对偏头痛的有益作用与非纤维肌痛患者相似,除了减少躯体疼痛和疾病的整体残疾。抗cgrp药物是治疗偏头痛合并纤维肌痛的一个很好的选择,目前尚无有效的治疗方法。
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来源期刊
Journal of Headache and Pain
Journal of Headache and Pain 医学-临床神经学
CiteScore
11.80
自引率
13.50%
发文量
143
审稿时长
6-12 weeks
期刊介绍: The Journal of Headache and Pain, a peer-reviewed open-access journal published under the BMC brand, a part of Springer Nature, is dedicated to researchers engaged in all facets of headache and related pain syndromes. It encompasses epidemiology, public health, basic science, translational medicine, clinical trials, and real-world data. With a multidisciplinary approach, The Journal of Headache and Pain addresses headache medicine and related pain syndromes across all medical disciplines. It particularly encourages submissions in clinical, translational, and basic science fields, focusing on pain management, genetics, neurology, and internal medicine. The journal publishes research articles, reviews, letters to the Editor, as well as consensus articles and guidelines, aimed at promoting best practices in managing patients with headaches and related pain.
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