The efficacy and safety of calcitonin gene-related peptide monoclonal antibody for episodic migraine: a meta-analysis
This meta-analysis was performed to evaluate the efficacy and safety of monoclonal antibodies against calcitonin gene-related peptide (CGRP) for episodic migraine prevention.
MEDLINE, EMBASE, Web of Science, and the Cochrane Library were searched from inception to April 2018. Studies considered to be eligible were randomized controlled trials about efficacy and safety of calcitonin gene-related peptide monoclonal antibody for episodic migraine prevention.
Eight randomized controlled trials involving 2292 patients were included. The outcomes of this meta-analysis presented that CGRP monoclonal antibodies for preventive treatment of episodic migraine significantly reduced the monthly migraine days from baseline [weighted mean difference (WMD) = − 1.52; 95%CI, − 1.92 to − 1.11; Z = 7.40; P < 0.001] and monthly acute migraine-specific medication consumption from baseline [WMD = − 1.45; 95%CI, − 2.17 to − 0.72; Z = 3.93; P < 0.001], as compared with placebo group. CGRP monoclonal antibodies for preventive treatment of episodic migraine significantly increased the ≥ 50% reduction from baseline in migraine days per month [RR = 1.54; 95%CI, 1.38 to1.71; Z = 7.88; P < 0.001]. The adverse events were similar between the CGRP monoclonal antibody group and placebo group (P = 0.998). The outcomes of subgroup analysis showed that erenumab, galcanezumab, and fremanezumab significantly reduced the monthly migraine days from baseline and increased the ≥ 50% reduction from baseline in migraine days per month. Both erenumab and fremanezumab significantly reduced from baseline.
Based on the results of this meta-analysis, CGRP monoclonal antibodies significantly reduced the monthly migraine days and acute migraine-specific medication. CGRP monoclonal antibodies were effective and safe for preventive treatment of episodic migraine.
KeywordsCalcitonin gene-related peptide monoclonal antibody Episodic migraine Meta-analysis Randomized controlled trial
Compliance with ethical standards
This study was not registered.
Conflict of interest
The authors declare that they have no competing interests.
- 1.Headache Classification Committee of the International Headache Society (2013) The international classification of headache disorders, 3rd edition (beta version). Cephalalgia 33:629–808Google Scholar
- 2.Lipton RB, Manack Adams A, Buse DC, Fanning KM, Reed ML (2016) A comparison of the Chronic Migraine Epidemiology and Outcomes (CaMEO) study and American Migraine Prevalence and Prevention (AMPP) study: demographics and headache-related disability. Headache 56:1280–1289CrossRefPubMedPubMedCentralGoogle Scholar
- 8.Higgins JP, Green S Cochrane handbook for systematic reviews of interventions (version 51.0). [cited 2012 Jan 5]. Available at: http://www.cochrane-handbook.org.
- 12.Dodick DW, Goadsby PJ, Silberstein SD et al (2014) Safety and efficacy of ALD403, an antibody to calciton in gene-related peptide, for the prevention of frequent episodic migraine: a randomised, double-blind, placebo-controlled, exploratory phase 2 trial. Lancet Neurol 13(9):1100–1107CrossRefPubMedGoogle Scholar
- 13.Skljarevski V, Oakes TM, Zhang Q, Ferguson MB, Martinez J, Camporeale A, Johnson KW, Shan Q, Carter J, Schacht A, Goadsby PJ, Dodick DW (2017) Effect of different doses of galcanezumab vs placebo for episodic migraine prevention: a randomized clinical trial. JAMA Neurol 75:187–193. https://doi.org/10.1001/jamaneurol.2017.3859. CrossRefPubMedCentralGoogle Scholar
- 18.Khan S, Olesen A, Ashina M et al (2017) CGRP, target for preventive therapy in migraine and cluster headache: systematic review of clinical data. Cephalalgia 333102417741297.Google Scholar
- 22.de Tommaso M, Sciruicchio V, Delussi M, Vecchio E, Goffredo M, Simeone M, Barbaro MGF (2017) Symptoms of central sensitization and comorbidity for juvenile fibromyalgia in childhood migraine: an observational study in a tertiary headache center. J Headache Pain 18(1):59CrossRefPubMedPubMedCentralGoogle Scholar