PMID- 37278480
OWN - NLM
STAT- MEDLINE
DCOM- 20230914
LR  - 20231002
IS  - 1536-5409 (Electronic)
IS  - 0749-8047 (Linking)
VI  - 39
IP  - 10
DP  - 2023 Oct 1
TI  - Comparative Efficacy and Safety of Five Anti-calcitonin Gene-related Peptide 
      Agents for Migraine Prevention: A Network Meta-analysis.
PG  - 560-569
LID - 10.1097/AJP.0000000000001136 [doi]
AB  - OBJECTIVES: Anti-calcitonin gene-related peptide (CGRP) agents are some of the 
      newest preventive medications for migraine. There is limited literature comparing 
      the efficacy of the most recent CGRP antagonist, atogepant, to CGRP monoclonal 
      antibodies for migraine prevention. In this network meta-analysis, the efficacy 
      and safety of migraine treatments including different doses of atogepant and CGRP 
      monoclonal antibodies were evaluated to provide a reference for future clinical 
      trials. MATERIALS AND METHODS: A search using PubMed, Embase, and Cochrane 
      Library identified all randomized controlled trials published through May 2022 
      and including patients diagnosed with episodic or chronic migraine and treated 
      with erenumab, fremanezumab, eptinezumab, galcanezumab, atogepant, or placebo. 
      The primary outcomes were the reduction of monthly migraine days, 50% response 
      rate, and the number of adverse events (AEs). The Cochrane Collaboration tool was 
      used to assess the risk of bias. RESULTS: In this study, 24 articles were 
      considered for analysis. Regarding efficacy, all interventions were superior to 
      placebo with a statistically significant difference. The most effective 
      intervention was monthly fremanezumab 225 mg in change from baseline of migraine 
      days (standard mean difference = -0.49, 95% CI: -0.62, -0.37) and 50% response 
      rate (risk ratio = 2.98, 95% CI: 2.16,4.10), while the optimal choice for 
      reducing acute medication days was monthly erenumab 140 mg (standard mean 
      difference = -0.68, 95% CI: -0.79, -0.58). In terms of AEs, all therapies and 
      placebo did not achieve statistical significance except for monthly galcanezumab 
      240 mg and quarterly fremanezumab 675 mg. There was no significant difference in 
      discontinuation due to AEs between interventions and placebo. DISCUSSION: All 
      anti-CGRP agents were more effective than placebo in migraine prevention. 
      Overall, monthly fremanezumab 225 mg, monthly erenumab 140 mg, and daily 
      atogepant 60 mg were effective interventions with fewer side effects.
CI  - Copyright (c) 2023 Wolters Kluwer Health, Inc. All rights reserved.
FAU - Sun, Wenfang
AU  - Sun W
AUID- ORCID: 0000-0001-7287-6923
AD  - Department of Pharmacy.
FAU - Cheng, Hua
AU  - Cheng H
AD  - Department of Pharmacy.
FAU - Xia, Binbin
AU  - Xia B
AD  - Department of Pharmacy.
FAU - Liu, Xianjun
AU  - Liu X
AD  - Department of Pharmacy.
FAU - Li, Yali
AU  - Li Y
AD  - Department of Pharmacy.
FAU - Wang, Xuemei
AU  - Wang X
AD  - Department of Neurology, Beijing Luhe Hospital, Capital Medical University, 
      Beijing.
FAU - Liu, Chengjiang
AU  - Liu C
AD  - Department of General, Practice, Anhui Medical University, Hefei, China.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
DEP - 20231001
PL  - United States
TA  - Clin J Pain
JT  - The Clinical journal of pain
JID - 8507389
RN  - JHB2QIZ69Z (Calcitonin Gene-Related Peptide)
RN  - 7CRV8RR151 (atogepant)
RN  - 0 (Antibodies, Monoclonal)
SB  - IM
MH  - Humans
MH  - *Calcitonin Gene-Related Peptide/therapeutic use
MH  - Network Meta-Analysis
MH  - *Migraine Disorders/drug therapy/prevention & control
MH  - Antibodies, Monoclonal/therapeutic use
MH  - Treatment Outcome
COIS- The authors declare no conflict of interest.
EDAT- 2023/06/06 13:09
MHDA- 2023/09/14 06:42
CRDT- 2023/06/06 08:22
PHST- 2022/11/30 00:00 [received]
PHST- 2023/05/22 00:00 [accepted]
PHST- 2023/09/14 06:42 [medline]
PHST- 2023/06/06 13:09 [pubmed]
PHST- 2023/06/06 08:22 [entrez]
AID - 00002508-990000000-00098 [pii]
AID - 10.1097/AJP.0000000000001136 [doi]
PST - epublish
SO  - Clin J Pain. 2023 Oct 1;39(10):560-569. doi: 10.1097/AJP.0000000000001136.