TY - JOUR
T1 - European Headache Federation guideline on the use of monoclonal antibodies targeting the calcitonin gene related peptide pathway for migraine prevention - 2022 update
AU - Sacco, Simona
AU - Amin, Faisal Mohammad
AU - Ashina, Messoud
AU - Bendtsen, Lars
AU - Deligianni, Christina I
AU - Gil-Gouveia, Raquel
AU - Katsarava, Zaza
AU - MaassenVanDenBrink, Antoinette
AU - Martelletti, Paolo
AU - Mitsikostas, Dimos-Dimitrios
AU - Ornello, Raffaele
AU - Reuter, Uwe
AU - Sanchez-Del-Rio, Margarita
AU - Sinclair, Alexandra J
AU - Terwindt, Gisela
AU - Uluduz, Derya
AU - Versijpt, Jan
AU - Lampl, Christian
N1 - © 2022. The Author(s).
PY - 2022/6/11
Y1 - 2022/6/11
N2 - 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.
AB - 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.
KW - Antibodies, Monoclonal/therapeutic use
KW - Calcitonin Gene-Related Peptide Receptor Antagonists/pharmacology
KW - Calcitonin Gene-Related Peptide/metabolism
KW - Headache/drug therapy
KW - Humans
KW - Migraine Disorders/drug therapy
KW - Prevention
KW - Calcitonin gene-related pathway
KW - Migraine
KW - Monoclonal antibodies
KW - Guideline
UR - http://www.scopus.com/inward/record.url?scp=85131902488&partnerID=8YFLogxK
U2 - 10.1186/s10194-022-01431-x
DO - 10.1186/s10194-022-01431-x
M3 - Review
C2 - 35690723
SN - 1129-2369
VL - 23
SP - 1
EP - 19
JO - Journal of Headache and Pain
JF - Journal of Headache and Pain
IS - 1
M1 - 67
ER -