Britt W H van der Arend, Floor C van Welie, Michael H Olsen, Jan Versijpt, Antoinette Maassen Van Den Brink, Gisela M Terwindt
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引用次数: 0
摘要
背景:针对降钙素基因相关肽(CGRP)或CGRP受体的单克隆抗体已经彻底改变了偏头痛的预防。尽管它们很有效,但人们担心CGRP的血管舒张功能会对心血管产生潜在的不良影响,这表明它对血压有潜在的影响。方法:系统检索截至2024年5月1日的PubMed、Cochrane系统综述数据库、Web of Science、MEDLINE和EMBASE。我们将重点放在随机对照试验和观察性队列或病例对照研究上,研究抗cgrp (R)单克隆抗体(mab)对偏头痛患者血压的影响,并与对照治疗进行比较。两名审稿人独立进行研究选择、数据提取和偏倚风险评估。结果:检索到文献693篇。在删除重复并进行筛选后,对22篇全文文章进行了评估,只有4篇研究符合纳入标准。其中,只有一项研究具有低偏倚风险,并报告了抗cgrp (R)-mAb治疗开始后血压升高。结论:尽管抗cgrp (R)- mab对偏头痛的预防有实质性的益处,但血压升高的潜在风险需要引起注意。尽管目前证据有限,但临床医生仍被敦促监测接受抗cgrp (R)-单克隆抗体治疗的偏头痛患者的血压,并保持对这些患者心血管事件风险增加的认识。
Impact of CGRP monoclonal antibody treatment on blood pressure in patients with migraine: A systematic review and potential clinical implications.
Background: Monoclonal antibodies targeting calcitonin gene-related peptide (CGRP) or the CGRP-receptor have revolutionized the prevention of migraine. Despite their effectiveness, worries have surfaced regarding potential unwanted cardiovascular effects linked to the vasodilation function of CGRP, suggesting a potential influence on blood pressure (BP).
Methods: Studies were systematically retrieved from PubMed, Cochrane Database of Systematic Reviews, Web of Science, MEDLINE and EMBASE up to 1 May 2024. We focused on randomized controlled trials and observational cohort or case-control studies examining the impact of anti-CGRP(R)-monoclonal antibodies (mAbs) compared to control treatments on BP in patients with migraine. Two reviewers independently conducted study selection, data extraction and risk of bias assessment.
Results: The literature search yielded 693 articles. After removing duplicates and conducting screening, 22 full-text articles were evaluated, with only four studies meeting the inclusion criteria. Among these, only one study had a low risk of bias and reported elevated BP following initiation of anti-CGRP(R)-mAb treatment.
Conclusions: Although anti-CGRP(R)-mAbs offer substantial benefits for migraine prevention, the potential risk of increased BP requires attention. Despite the current limited evidence, clinicians are urged to monitor BP of migraine patients undergoing treatment with anti-CGRP(R)-mAbs and to remain aware of the increased risk of cardiovascular events in these patients.
期刊介绍:
Cephalalgia contains original peer reviewed papers on all aspects of headache. The journal provides an international forum for original research papers, review articles and short communications. Published monthly on behalf of the International Headache Society, Cephalalgia''s rapid review averages 5 ½ weeks from author submission to first decision.