抗cgrp单克隆抗体治疗65岁以上偏头痛患者的有效性和安全性:一项系统综述

IF 1.4 Q4 CLINICAL NEUROLOGY
Pain management Pub Date : 2025-03-01 Epub Date: 2025-03-03 DOI:10.1080/17581869.2025.2470615
Albert Muñoz-Vendrell, Alba López-Bravo, Almudena Layos-Romero, Francisco J Alberola-Amores, María Obdulia Lozano Caballero, Antonio Sánchez-Soblechero, Cristian Morales-Hernández, María Victoria Castro-Sánchez, María Pilar Navarro-López, María Rocío Córdova-Infantes, Edoardo Caronna, Pablo Irimia, Alicia Gonzalez-Martinez
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引用次数: 0

摘要

背景:65岁以上的偏头痛患者被排除在关键抗cgrp单克隆抗体试验之外,这一人群的有效性和安全性的实际数据有限。本综述旨在总结有关老年患者治疗反应和安全性的现有证据。方法:PubMed和Cochrane对照试验登记(CENTRAL)检索确定了截至2024年10月65岁以上偏头痛患者抗cgrp单克隆抗体的研究。该综述的重点是头痛结局,如每月偏头痛天数或每月头痛天数减少、反应率(30%、50%、75%)以及该特定人群和/或对照安慰剂、标准治疗或年轻患者的不良反应。使用GRADE工具评估证据质量。结果:所有符合条件的研究都被纳入,以及额外的叙述性文章。来自临床试验和事后分析的数据显示,老年和年轻患者的疗效和安全性相当。同样,早期的现实生活研究支持在65岁以上的患者中使用抗cgrp单克隆抗体,显示出相似的反应率,每月偏头痛天数减少和不良反应。讨论:抗cgrp单克隆抗体可能应该提供给65岁以上的患者,尽管现有证据仍然有限。有必要进一步研究分析这一群体的具体数据。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Effectiveness and safety of anti-CGRP monoclonal antibodies for migraine in patients over 65 years: a systematic review.

Background: Migraine patients over 65 years have been excluded from pivotal anti-CGRP monoclonal antibody trials leaving limited real-life data on effectiveness and safety in this population. This review aims to summarize available evidence on treatment response and safety for older patients.

Methods: A PubMed and Cochrane Controlled Register of Trials (CENTRAL) search identified studies on anti-CGRP monoclonal antibodies in patients with migraine over 65 up to October 2024. The review focuses on headache outcomes like reduction in monthly migraine days or monthly headache days, response rates (30%, 50%, 75%) and adverse effects of this specific population and/or against placebo, standard care, or younger patients. The quality of evidence was assessed using the GRADE tool.

Results: All eligible studies were included, along with additional articles presented narratively. Data from clinical trials and post-hoc analyses show comparable efficacy and safety between older and younger patients. Similarly, early real-life studies support the use of anti-CGRP monoclonal antibodies in patients over 65 years, showing similar response rates, reductions in monthly migraine days and adverse effects.

Discussion: Anti-CGRP monoclonal antibodies should likely be offered to patients over 65 although available evidence remains limited. Further studies analyzing specific data from this subgroup are necessary.

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来源期刊
Pain management
Pain management CLINICAL NEUROLOGY-
CiteScore
2.90
自引率
5.90%
发文量
62
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