Nancy van Veelen, Britt W. H. van der Arend, E. Hiele, E. W. van Zwet, Gisela M. Terwindt
{"title":"无应答者从配体到受体的抗降钙素基因相关肽(CGRP)抗体转换或相反:一项对照队列研究。","authors":"Nancy van Veelen, Britt W. H. van der Arend, E. Hiele, E. W. van Zwet, Gisela M. Terwindt","doi":"10.1111/ene.16542","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background and purpose</h3>\n \n <p>Limited options exist for migraine prevention after stopping anti-calcitonin gene-related peptide monoclonal antibodies. A systematic review examining the benefits of switching between different classes (ligand vs. receptor monoclonal antibody) is essential, alongside well-designed real-world studies.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>In this cohort study 67 patients were included, who discontinued their first treatment with erenumab or fremanezumab. Patients (<i>n</i> = 31) switched to another monoclonal antibody class within 3 months, whilst those in the control group (<i>n</i> = 36) received standard care. Allocation to either group relied largely on the availability of alternative monoclonal antibody treatments, introducing pseudo-random allocation. Changes in monthly migraine days were compared between groups 3 months post-discontinuation of the first monoclonal antibody or initiation of a different monoclonal antibody class. A multivariate regression model was conducted that accounted for potential confounding factors.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>The groups were comparable at baseline and poor treatment response was the main reason for treatment discontinuation of the first monoclonal antibody. The switching cohort experienced a reduction of 3.9 monthly migraine days (95% confidence interval −6.4, −1.3, <i>p</i> = 0.004) compared with the control group.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Transitioning to a different anti-calcitonin gene-related peptide monoclonal class yields reduction in monthly migraine days compared to returning to standard care for patients with inadequate initial treatment response.</p>\n </section>\n </div>","PeriodicalId":11954,"journal":{"name":"European Journal of Neurology","volume":"32 1","pages":""},"PeriodicalIF":4.5000,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11625943/pdf/","citationCount":"0","resultStr":"{\"title\":\"Switching from ligand to receptor anti-calcitonin gene-related peptide (CGRP) antibodies or vice versa in non-responders: A controlled cohort study\",\"authors\":\"Nancy van Veelen, Britt W. H. van der Arend, E. Hiele, E. W. van Zwet, Gisela M. Terwindt\",\"doi\":\"10.1111/ene.16542\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background and purpose</h3>\\n \\n <p>Limited options exist for migraine prevention after stopping anti-calcitonin gene-related peptide monoclonal antibodies. A systematic review examining the benefits of switching between different classes (ligand vs. receptor monoclonal antibody) is essential, alongside well-designed real-world studies.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>In this cohort study 67 patients were included, who discontinued their first treatment with erenumab or fremanezumab. Patients (<i>n</i> = 31) switched to another monoclonal antibody class within 3 months, whilst those in the control group (<i>n</i> = 36) received standard care. 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Switching from ligand to receptor anti-calcitonin gene-related peptide (CGRP) antibodies or vice versa in non-responders: A controlled cohort study
Background and purpose
Limited options exist for migraine prevention after stopping anti-calcitonin gene-related peptide monoclonal antibodies. A systematic review examining the benefits of switching between different classes (ligand vs. receptor monoclonal antibody) is essential, alongside well-designed real-world studies.
Methods
In this cohort study 67 patients were included, who discontinued their first treatment with erenumab or fremanezumab. Patients (n = 31) switched to another monoclonal antibody class within 3 months, whilst those in the control group (n = 36) received standard care. Allocation to either group relied largely on the availability of alternative monoclonal antibody treatments, introducing pseudo-random allocation. Changes in monthly migraine days were compared between groups 3 months post-discontinuation of the first monoclonal antibody or initiation of a different monoclonal antibody class. A multivariate regression model was conducted that accounted for potential confounding factors.
Results
The groups were comparable at baseline and poor treatment response was the main reason for treatment discontinuation of the first monoclonal antibody. The switching cohort experienced a reduction of 3.9 monthly migraine days (95% confidence interval −6.4, −1.3, p = 0.004) compared with the control group.
Conclusion
Transitioning to a different anti-calcitonin gene-related peptide monoclonal class yields reduction in monthly migraine days compared to returning to standard care for patients with inadequate initial treatment response.
期刊介绍:
The European Journal of Neurology is the official journal of the European Academy of Neurology and covers all areas of clinical and basic research in neurology, including pre-clinical research of immediate translational value for new potential treatments. Emphasis is placed on major diseases of large clinical and socio-economic importance (dementia, stroke, epilepsy, headache, multiple sclerosis, movement disorders, and infectious diseases).