Brazilian descriptive study of 104 consecutive real-world migraine patients treated with monoclonal antibodies

ABSTRACT

Background

Migraine is a highly disabling and prevalent neurological disorder. A peptide, calcitonin gene-related peptide, was identified as involved in migraine pathophysiology and monoclonal anti-CGRP antibodies have been developed.

Aim

To describe the clinical characteristics and therapeutic response of migraine patients treated with monoclonal antibodies.

Method

An observational, prospective, uncontrolled, and descriptive study was carried out with a sample of 112 consecutive patients with episodic or chronic migraine treated with monoclonal antibodies. Eight patients did not return for the following medical consultation. They were excluded from the study.

Results

A total of 104 patients were described. There was a predominance of episodic migraine. Before treatment, the average frequency of headache was 15.3 ± 8.5 days per month, during the previous three months. Monoclonal antibodies were prescribed at the following frequency: erenumab (49%), galcanezumab (45.2%), and fremanezumab (5.8%). After the third month, the reduction in headache attacks was greater than 50% in 57.7% of patients. Adverse events were referred by 18.3% of patients, in this order of frequency: constipation (7.7%), insomnia (2.9%), vertigo (1.9%), erythema at the injection site (1.9%), arthralgia (1%), nasopharyngitis (1%), facial and hand edema (1%), irritation at the injection site (1%), and paresthesia at the injection site (1%).

Conclusions

This described analysis of migraine patients who used monoclonal antibodies presented one of the first Brazilian experiences with real-world patients. Our results may enlighten clinicians on the outcomes and ways of prescribing anti-CGRP antibodies.

KEYWORDS:

• Migraine
• preventive treatment
• CGRP
• monoclonal antibodies
• real-world evidence

Disclosure of any financial/other conflicts of interest

The authors have no relevant conflicts of interest to disclose. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Contributors

All authors contributed equally.

Additional information

Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.