Galcanezumab 加载剂量用于偏头痛预防后的脑动脉血管收缩:病例报告。

IF 4.1 2区 医学 Q1 CLINICAL NEUROLOGY
Pain and Therapy Pub Date : 2024-12-01 Epub Date: 2024-10-04 DOI:10.1007/s40122-024-00665-8
Thanin Asawavichienjinda, Nutchawan Jittapiromsak, Andrew Blumenfeld
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引用次数: 0

摘要

以 CGRP 配体或受体为靶点的抗降钙素基因相关肽(CGRP)单克隆抗体可能会导致一种非常罕见的副作用,即可逆性脑血管收缩综合征(RCVS)。本研究报告了一例患者的病例,该患者在服用 galcanezumab 负荷剂量后出现了脑动脉血管收缩,连续的脑磁共振血管造影(MRA)扫描记录显示其没有 RCVS 的典型表现。病例报告:一位 40 岁的女性患者,患有高频发作性偏头痛并伴有视觉先兆,服用托吡酯 100 毫克/天,在加载剂量 galcanezumab 10 分钟后出现短暂的右上下肢和右脸麻木,但无头痛,神经系统检查正常。磁共振血管成像脑成像显示,M1-2段的两侧大脑中动脉和P1-2段的两侧大脑后动脉出现节段性动脉收缩,在随后的研究中,6个月后部分收缩消失。没有其他辅助检查数据(如经颅多普勒)可以为血管收缩的进展和改善提供更多信息。她的鉴别诊断包括无头痛的长期偏头痛感觉先兆、RCVS或继发于抗CGRP单克隆抗体效应的脑血管收缩。还需要进一步研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Cerebral Artery Vasoconstriction After Galcanezumab Loading Dose for Migraine Prevention: A Case Report.

Anti-calcitonin gene-related peptide (CGRP) monoclonal antibodies that target CGRP ligands or receptors, may cause a very rare side effect of reversible cerebral vasoconstriction syndrome (RCVS). This study is a case report of a patient who developed cerebral artery vasoconstriction documented on serial brain magnetic resonance angiography (MRA) scans without the typical manifestations of RCVS following galcanezumab loading dose. Case report: A 40-year-old female patient with high-frequency episodic migraine with visual aura on topiramate 100 mg/day developed transient numbness of the right upper and lower extremities and right face without headache and a normal neurological examination 10 min after a loading dose of galcanezumab, which resolved over the next 2 days. Magnetic resonance angiography brain imaging showed segmental arterial constriction of both middle cerebral arteries in the M1-2 segments and both posterior cerebral arteries in the P1-2 segments, which partial resolved in a subsequent study by the end of 6 months. There were no other supporting examination data, such as transcranial Doppler, which might provide additional information on the progression and improvement of the vasoconstriction. Her differential diagnosis included prolonged migraine sensory aura without headache, RCVS, or cerebral vasoconstriction secondary to the effect of an anti-CGRP monoclonal antibody. Further research needs to be conducted.

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来源期刊
Pain and Therapy
Pain and Therapy CLINICAL NEUROLOGY-
CiteScore
6.60
自引率
5.00%
发文量
110
审稿时长
6 weeks
期刊介绍: Pain and Therapy is an international, open access, peer-reviewed, rapid publication journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of pain therapies and pain-related devices. Studies relating to diagnosis, pharmacoeconomics, public health, quality of life, and patient care, management, and education are also encouraged. Areas of focus include, but are not limited to, acute pain, cancer pain, chronic pain, headache and migraine, neuropathic pain, opioids, palliative care and pain ethics, peri- and post-operative pain as well as rheumatic pain and fibromyalgia. The journal is of interest to a broad audience of pharmaceutical and healthcare professionals and publishes original research, reviews, case reports, trial protocols, short communications such as commentaries and editorials, and letters. The journal is read by a global audience and receives submissions from around the world. Pain and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.
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