Fabrizio Vernieri1, Claudia Altamura1, Nicoletta Brunelli1, Carmelina Maria Costa1, Cinzia Aurilia2, Gabriella Egeo2, Luisa Fofi2, Valentina Favoni3, Carlo Lovati4, Davide Bertuzzo5, Florindo d'Onofrio6, Alberto Doretti7, Paola Di Fiore8, Cinzia Finocchi9, Francesca Schiano Di Cola10, Angelo Ranieri11, Bruno Colombo12, Francesco Bono13, Maria Albanese14,15, Sabina Cevoli3, Piero Barbanti2,16. 1. Headache and Neurosonology Unit, Campus Bio-Medico University Hospital, Rome, Italy. 2. Headache and Pain Unit, San Raffaele Pisana, Scientific Institute for Research and Health Care, Rome, Italy. 3. Bologna Institute of Neurological Sciences, Scientific Institute for Research and Health Care, Bologna, Italy. 4. Neurology Unit, Headache Center, L. Sacco University Hospital, Milan, Italy. 5. Neurology and Stroke Unit, Asti Hospital, Asti, Italy. 6. Neurology Unit, San Giuseppe Moscati Hospital, Avellino, Italy. 7. Department of Neurology, Stroke Unit and Laboratory of Neuroscience, Italian Auxological Institute, Scientific Institute for Research and Health Care, Milan, Italy. 8. Headache Center, Neurology and Stroke Unit, S. Carlo Borromeo Hospital, Milan, Italy. 9. San Martino Polyclinic Hospital, Scientific Institute for Research and Health Care, Genoa, Italy. 10. Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy. 11. Headache Center, Neurology and Stroke Unit, A. Cardarelli Hospital, Naples, Italy. 12. San Raffaele Hospital, Scientific Institute for Research and Health Care, Vita-Salute San Raffaele University, Milan, Italy. 13. Center for Headache and Intracranial Pressure Disorders, Neurology Unit, Mater Domini University Hospital, Catanzaro, Italy. 14. Headache Center, Neurology Unit, Tor Vergata University Hospital, Rome, Italy. 15. Department of Systems Medicine, Tor Vergata University, Rome, Italy. 16. San Raffaele University, Rome, Italy.
Abstract
BACKGROUND AND PURPOSE: A rapid response to preventive therapy is of pivotal importance in severely disabled patients with chronic migraine (CM) and diverse preventive treatment failures. This prospective, observational, multicenter real-life study aimed at investigating the effectiveness of galcanezumab in the first 3 months of treatment of CM patients at 14 Italian headache centers. METHODS: All consecutive adult patients with CM diagnosis with the clinical indication for galcanezumab were considered. We collected patients' baseline characteristics, monthly headache days, monthly painkiller intake, migraine clinical characteristics, and disability scale scores during a 1-month run-in period (baseline) and the first 3 months of therapy. Possible predictive factors of treatment were considered. RESULTS: A total of 156 patients (82.4% female, aged 47.3 ± 12.3 years) were enrolled. The 65 (41.7%) patients with a consecutive ≥50% response rate (RR) in the 3 months of therapy presented a lower body mass index (p = 0.004) and more frequently presented unilateral migraine pain (p = 0.002) and good response to triptans (p = 0.003). Persistent conversion from CM to episodic migraine was observed in 55.8% (87/156) of patients. They more frequently presented a good response to triptans (p = 0.003) and unilateral pain (p = 0.046). At baseline, 131 of 156 (83.9%) patients presented medication overuse (MO). Of these, 61.8% (81/131) no longer displayed MO consistently during the 3 months. These patients were more frequently responders to triptans (p = 0.002) and less frequently suffered from gastrointestinal comorbidity (p = 0.007). CONCLUSIONS: Unilateral pain, good response to triptans, and normal weight may be associated with a persistent positive response in the first 3 months of therapy with galcanezumab in CM patients.
BACKGROUND AND PURPOSE: A rapid response to preventive therapy is of pivotal importance in severely disabled patients with chronic migraine (CM) and diverse preventive treatment failures. This prospective, observational, multicenter real-life study aimed at investigating the effectiveness of galcanezumab in the first 3 months of treatment of CM patients at 14 Italian headache centers. METHODS: All consecutive adult patients with CM diagnosis with the clinical indication for galcanezumab were considered. We collected patients' baseline characteristics, monthly headache days, monthly painkiller intake, migraine clinical characteristics, and disability scale scores during a 1-month run-in period (baseline) and the first 3 months of therapy. Possible predictive factors of treatment were considered. RESULTS: A total of 156 patients (82.4% female, aged 47.3 ± 12.3 years) were enrolled. The 65 (41.7%) patients with a consecutive ≥50% response rate (RR) in the 3 months of therapy presented a lower body mass index (p = 0.004) and more frequently presented unilateral migraine pain (p = 0.002) and good response to triptans (p = 0.003). Persistent conversion from CM to episodic migraine was observed in 55.8% (87/156) of patients. They more frequently presented a good response to triptans (p = 0.003) and unilateral pain (p = 0.046). At baseline, 131 of 156 (83.9%) patients presented medication overuse (MO). Of these, 61.8% (81/131) no longer displayed MO consistently during the 3 months. These patients were more frequently responders to triptans (p = 0.002) and less frequently suffered from gastrointestinal comorbidity (p = 0.007). CONCLUSIONS: Unilateral pain, good response to triptans, and normal weight may be associated with a persistent positive response in the first 3 months of therapy with galcanezumab in CM patients.
Authors: Maurice T Driessen; Joshua M Cohen; Stephen F Thompson; Oscar Patterson-Lomba; Michael J Seminerio; Karen Carr; Todor I Totev; Rochelle Sun; Erica Yim; Fan Mu; Rajeev Ayyagari Journal: J Headache Pain Date: 2022-05-16 Impact factor: 8.588
Authors: Magdalena Nowaczewska; Marcin Straburzyński; Marta Waliszewska-Prosół; Grzegorz Meder; Joanna Janiak-Kiszka; Wojciech Kaźmierczak Journal: Front Neurol Date: 2022-05-17 Impact factor: 4.086