European Headache Federation guideline on the use of monoclonal antibodies targeting the calcitonin gene related peptide pathway for migraine prevention – 2022 update

The Journal of Headache and Pain

Dimos-Dimitrios Mitsikostas¹  Zaza Katsarava²  Lars Bendtsen³  Messoud Ashina³  Christina I. Deligianni³  Faisal Mohammad Amin³  Simona Sacco⁴  Raffaele Ornello⁴  Paolo Martelletti⁵  Antoinette MaassenVanDenBrink⁶  Derya Uluduz⁷  Uwe Reuter⁸  Margarita Sanchez-del-Rio⁹  Christian Lampl^1,10  Gisela Terwindt^1,11  Jan Versijpt^1,12  Raquel Gil-Gouveia^1,13  Alexandra J. Sinclair^1,14 

[1] 1st Department of Neurology, Aeginition Hospital, School of Medicine, National and Kapodistrian University of Athens;Christian Hospital Unna;Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, University of Copenhagen;Department of Biotechnological and Applied Clinical Sciences – University of L’Aquila;Department of Clinical and Molecular Medicine, Sapienza University;Department of Internal Medicine, Erasmus MC Medical Center;Department of Neurology Istanbul Cerrahpasa Medical Faculty;Department of Neurology, Charité Universitätsmedizin Berlin;Department of Neurology, Clinica Universidad de Navarra;Department of Neurology, Headache Medical Center at the Konventhospital BHB Linz;Department of Neurology, Leiden University Medical Center;Department of Neurology, Vrije Universiteit Brussel (VUB), Universitair, Ziekenhuis Brussel (UZ Brussel);Hospital da Luz Headache Center, Neurology Department, Hospital da Luz Lisboa;Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham;

关键词: Monoclonal antibodies;    Calcitonin gene-related pathway;    Guideline;    Migraine;    Prevention;   

DOI  :  10.1186/s10194-022-01431-x

来源: DOAJ

【 摘 要 】

Abstract Background A previous European Headache Federation (EHF) guideline addressed the use of monoclonal antibodies targeting the calcitonin gene-related peptide (CGRP) pathway to prevent migraine. Since then, randomized controlled trials (RCTs) and real-world evidence have expanded the evidence and knowledge for those treatments. Therefore, the EHF panel decided to provide an updated guideline on the use of those treatments. Methods The guideline was developed following the Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) approach. The working group identified relevant questions, performed a systematic review and an analysis of the literature, assessed the quality of the available evidence, and wrote recommendations. Where the GRADE approach was not applicable, expert opinion was provided. Results We found moderate to high quality of evidence to recommend eptinezumab, erenumab, fremanezumab, and galcanezumab in individuals with episodic and chronic migraine. For several important clinical questions, we found not enough evidence to provide evidence-based recommendations and guidance relied on experts’ opinion. Nevertheless, we provided updated suggestions regarding the long-term management of those treatments and their place with respect to the other migraine preventatives. Conclusion Monoclonal antibodies targeting the CGRP pathway are recommended for migraine prevention as they are effective and safe also in the long-term.

【 授权许可】

Unknown