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Impact of anti-CGRP mAb discontinuation and reinitiation in chronic migraine


 

Key clinical point: Discontinuation of anticalcitonin gene-related protein (CGRP) monoclonal antibodies (mAb) leads to a progressive increase in monthly migraine days (MMD) and analgesic use from the first month, which, on reinitiation, revert to values comparable with those in the last month of treatment.

Main finding: At months 2 and 3 after discontinuation, a significant increase in MMD ( P = .003 and P < . 001, respectively) and analgesic use (both P < . 001) was observed compared with month 12 of treatment. In the reinitiation month, the MMD ( P = .40), days with ≥1 analgesic used ( P = .83), and number of analgesics used ( P = .74) were similar to the treatment month 12 values.

Study details: Findings are from a single-center, prospective, observational study involving 44 patients >18 years of age with treatment-resistant chronic migraine who received erenumab or galcanezumab for 12 months before a 3-month treatment discontinuation phase and 1 month of reinitiation.

Disclosures: The study received no specific funding. Some authors reported receiving personal fees or grants from various sources.

Source: Iannone LF et al. Eur J Neurol. 2022 (Jan 31). Doi: 10.1111/ene.15260

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