Details

Autor(en) / Beteiligte

• Cresta, Elena
• Bellotti, Alessia
• Rinaldi, Giovanni
• Corbelli, Ilenia
• Sarchielli, Paola

Titel

Effect of anti‐CGRP‐targeted therapy on migraine aura: Results of an observational case series study

Ist Teil von

• CNS neuroscience & therapeutics, 2024-02, Vol.30 (2), p.e14595-n/a

Ort / Verlag

England: John Wiley & Sons, Inc

Erscheinungsjahr

2024

Link zum Volltext

Quelle

Wiley Online Library

Beschreibungen/Notizen

• Introduction Limited clinical evidence is available regarding the potential effectiveness of anti‐CGRP monoclonal antibodies for the preventive treatment of migraine with aura. Aim of the Study This observational study involved a series of migraine patients affected by either migraine with or without aura, who were investigated for any changes in their frequencies and their migraine aura attack characteristics observed during treatment with anti‐CGRP Mabs over a 1‐year period. Patients and Methods Twelve migraine patients were included, seven of whom were treated with erenumab, 2 with fremanezumab, and 3 with galcanezumab. Clinical data were collected at baseline, which were defined as 3 months prior to the initiation of treatment, and thereafter at each trimester, over the 1‐year treatment period. The parameters included the number of headache and migraine days/month, the frequency of aura episodes, the number of days with acute drug intakes/month, and the scores from the migraine disability status scale (MIDAS), and the Headache Impact Test 6 (HIT‐6). Results Anti‐CGRP Mbs antibodies induced significant decreases in mean headache and migraine without aura days per month, the number of days with medication intake, as well as MIDAS and HIT‐6 scores (p < 0.0001). In contrast, the anti‐CGRP Mab treatment did not appear to impact the frequency of migraine with aura attacks but seemed to reduce both the intensity and the duration of headache phases of migraine aura. Furthermore, some migraine patients referred to having aura attacks without headache over the course of the treatment period. Conclusions Based on the above findings, we hypothesize that anti‐CGRP Mabs did not influence neuronal and vascular events related to cortical spreading depression (CSD) which is considered the pathophysiological substrate of aura. Conversely, these antibodies are able to counteract, via their peripheral mechanisms of action, the sensitization of the trigemino‐vascular pathway which is triggered by CSD. This aforementioned might explain why in our patients, migraine aura attacks remained unchanged in their frequencies, but the headache phases were either reduced or absent. This observational study involving a series of migraine patients affected by both migraine with and without aura reveals that anti‐CGRP antibodies induced a significant decrease in headache frequency of migraine without aura but not of migraine with aura attacks. Conversely, a reduction of the frequency and intensity of the headache phase of migraine aura and sometimes aura episodes without headache were recorded.