顺序使用OnabotulinumtoxinA和Erenumab治疗慢性偏头痛：双向切换的回顾性真实世界报告。

IF 4.8 3区医学 Q1 CLINICAL NEUROLOGY

Neurology and Therapy Pub Date : 2025-10-01 Epub Date: 2025-08-02 DOI:10.1007/s40120-025-00803-0

Carolin Luisa Hoehne, Aysenur Sahin, Lucas Hendrik Overeem, Kristin Sophie Lange, Mira Pauline Fitzek, Cornelius Angerhöfer, Uwe Reuter, Bianca Raffaelli

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引用次数: 0

摘要

在临床实践中，慢性偏头痛患者在疗效不足或耐受性差时，在预防治疗之间切换是很常见的。随着更多靶向治疗的出现，如肉毒杆菌毒素和降钙素基因相关肽（CGRP）单克隆抗体，治疗选择已经扩大，但指导测序决策的证据仍然有限。本研究的目的是调查对初始预防性治疗反应不足的慢性偏头痛患者在onabotulinumtoxinA和erenumab之间切换的实际有效性，反之亦然。方法：这项回顾性现实世界研究纳入了2022年10月至2024年12月期间在柏林头痛中心Charité-Universitätsmedizin治疗的慢性偏头痛患者。符合条件的患者先后接受了onabotulinumtoxinA和erenumab，由于疗效或耐受性不足而切换。非常好的反应定义为在转换后的第三个月每月头痛天数减少≥50%。结果：在632例筛查患者中，78例符合纳入标准(84.6%为女性；平均年龄（43±14岁）。其中54例从单肉毒杆菌毒素a切换到单肉毒杆菌a， 24例从单肉毒杆菌a切换到单肉毒杆菌a。14例患者（17.9%）观察到非常好的反应：切换到erenumab后10/54(18.5%)，切换到onabotulinumtoxinA后4/24（16.7%）。结论：onabotulinumtoxinA和erenumab的序贯预防治疗在约五分之一的患者中取得了很好的疗效。尽管这两种治疗都以CGRP通路为靶点，但它们不同的作用机制仍可能在初始失败后转换治疗时提供益处。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Sequential use of OnabotulinumtoxinA and Erenumab in Chronic Migraine: Retrospective Real-World Report on Bidirectional Switching.

查看原文本刊更多论文

Sequential use of OnabotulinumtoxinA and Erenumab in Chronic Migraine: Retrospective Real-World Report on Bidirectional Switching.

Introduction: In clinical practice, switching between preventive treatments is common in patients with chronic migraine when efficacy is insufficient or tolerability is poor. With the advent of more targeted therapies, such as onabotulinumtoxinA and calcitonin gene-related peptide (CGRP) monoclonal antibodies, treatment options have expanded, yet evidence to guide sequencing decisions remains limited. The aim of this study was to investigate the real-world effectiveness of switching between onabotulinumtoxinA and erenumab and vice versa in patients with chronic migraine who showed inadequate response to their initial preventive treatment.

Methods: This retrospective real-world study included patients with chronic migraine treated at the Headache Center, Charité-Universitätsmedizin Berlin between October 2022 and December 2024. Eligible patients had received both onabotulinumtoxinA and erenumab in sequence, switching as a result of insufficient efficacy or tolerability. A very good response was defined as a ≥ 50% reduction in monthly headache days in the third month after the switch.

Results: Out of 632 screened patients, 78 met the inclusion criteria (84.6% female; mean age 43 ± 14 years). Of these, 54 switched from onabotulinumtoxinA to erenumab, and 24 from erenumab to onabotulinumtoxinA. A very good response was observed in 14 patients (17.9%): 10/54 (18.5%) after switching to erenumab and 4/24 (16.7%) after switching to onabotulinumtoxinA.

Conclusion: Sequential preventive treatment with onabotulinumtoxinA and erenumab resulted in a very good response in about one-fifth of patients. Although both treatments target the CGRP pathway, their distinct mechanisms of action may still provide benefit when switching therapies after initial failure.

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来源期刊

Neurology and Therapy CLINICAL NEUROLOGY-

CiteScore

5.40

自引率

8.10%

发文量

103

审稿时长

6 weeks

期刊介绍： Aims and Scope Neurology and Therapy aims to provide reliable and inclusive, rapid publication for all therapy related research for neurological indications, supporting the timely dissemination of research with a global reach, to help advance scientific discovery and support clinical practice. Neurology 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 neurological and psychiatric therapies, (also covering surgery and devices). Studies relating to diagnosis, pharmacoeconomics, public health, quality of life, and patient care, management, and education are also welcomed. The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, case reports, trial designs, communications and letters. 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