PMID- 38361080
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240322
IS  - 2193-8253 (Print)
IS  - 2193-6536 (Electronic)
IS  - 2193-6536 (Linking)
VI  - 13
IP  - 2
DP  - 2024 Apr
TI  - Safety and Tolerability of Combining CGRP Monoclonal Antibodies with Gepants in 
      Patients with Migraine: A Retrospective Study.
PG  - 465-473
LID - 10.1007/s40120-024-00586-w [doi]
AB  - INTRODUCTION: The introduction of clacitonin gene-related peptide (CGRP) 
      monoclonal antibodies (mAbs) has revolutionized the treatment of migraines. In 
      clinical practice gepants might be considered as a valid option to treat acute 
      attacks in patients with migraine who are treated with mAbs. However, the safety 
      and tolerability of such a combination is not well addressed in the real-world 
      setting. We designed this study to evaluate the safety and tolerability of 
      combining CGRP mAbs with gepants in the management of migraines. METHODS: This 
      was a retrospective, real-world, exploratory study. The participants included 
      within the study were adult (>/= 18 years) patients diagnosed with migraine. 
      Screening for patients who were treated with at least one GCRP mAbs was done. 
      Data was collected from one site, the American Center for Psychiatry and 
      Neurology, Abu Dhabi UAE. A total of 516 patients taking CGRP mAbs were 
      identified. Extracted data from patients' electronic medical records included 
      patient demographics, migraine characteristics, prescribed treatments, and 
      adverse events (AEs). The tolerability and safety of the combination therapy was 
      evaluated on the basis of documented AEs. RESULTS: Among the identified 516 
      patients, 234 were administered gepants in addition to the CRGP mAb (215, 
      rimegepant; 19, ubrogepant). Eleven of the 234 patients switched from rimegepant 
      to urogepant as a result of lack of efficacy; one patient switched from urogepant 
      to zolmitriptan because of the lack of insurance coverage of the former 
      medication. Among all the patients included in this study, three AEs were 
      documented. These AEs were generally mild and transient and hence did not lead to 
      discontinuation of treatment. Moreover, 42 of the 234 (17.9%) patients were 
      switched from one class of CGRP mAbs to another at least once while continuing 
      treatment with the assigned gepants. CONCLUSION: The findings of this study 
      demonstrate that combining CGRP mAbs with gepants is a safe and well-tolerated 
      treatment approach for migraine. Future studies are warranted to further validate 
      these findings and explore long-term outcomes.
CI  - (c) 2024. The Author(s).
FAU - Alsaadi, Taoufik
AU  - Alsaadi T
AUID- ORCID: 0000-0002-7513-5706
AD  - Department of Neurology, American Center for Psychiatry and Neurology, Abu Dhabi, 
      UAE. talsaadi@live.ca.
FAU - Suliman, Reem
AU  - Suliman R
AUID- ORCID: 0009-0002-9607-3353
AD  - Department of Neurology, American Center for Psychiatry and Neurology, Abu Dhabi, 
      UAE. Rk.suliman16@gmail.com.
FAU - Santos, Vanessa
AU  - Santos V
AD  - Department of Neurology, American Center for Psychiatry and Neurology, Abu Dhabi, 
      UAE.
FAU - Al Qaisi, Ibrahim
AU  - Al Qaisi I
AD  - Department of Neurology, American Center for Psychiatry and Neurology, Abu Dhabi, 
      UAE.
FAU - Carmina, Princess
AU  - Carmina P
AD  - Department of Neurology, American Center for Psychiatry and Neurology, Abu Dhabi, 
      UAE.
FAU - Aldaher, Batool
AU  - Aldaher B
AD  - Department of Neurology, American Center for Psychiatry and Neurology, Abu Dhabi, 
      UAE.
FAU - Haddad, Shadi
AU  - Haddad S
AD  - Department of Neurology, American Center for Psychiatry and Neurology, Abu Dhabi, 
      UAE.
FAU - Bader, Yazan
AU  - Bader Y
AD  - Department of Neurology, American Center for Psychiatry and Neurology, Abu Dhabi, 
      UAE.
LA  - eng
PT  - Journal Article
DEP - 20240215
PL  - New Zealand
TA  - Neurol Ther
JT  - Neurology and therapy
JID - 101637818
PMC - PMC10951184
OTO - NOTNLM
OT  - CGRP mAbs
OT  - Eptinezumab
OT  - Erenumab
OT  - Gepants
OT  - Migraine
OT  - Safety
OT  - Tolerability
OT  - UAE
COIS- Batool Al Daher, Ibrahim Al Qaisi, Princess Carmina, Reem Suliman, Shadi Haddad, 
      Taoufik AlSaadi, and Yazan Bader have no competing interests and nothing to 
      disclose.
EDAT- 2024/02/16 06:43
MHDA- 2024/02/16 06:44
PMCR- 2024/02/15
CRDT- 2024/02/16 00:03
PHST- 2023/12/25 00:00 [received]
PHST- 2024/01/29 00:00 [accepted]
PHST- 2024/02/16 06:44 [medline]
PHST- 2024/02/16 06:43 [pubmed]
PHST- 2024/02/16 00:03 [entrez]
PHST- 2024/02/15 00:00 [pmc-release]
AID - 10.1007/s40120-024-00586-w [pii]
AID - 586 [pii]
AID - 10.1007/s40120-024-00586-w [doi]
PST - ppublish
SO  - Neurol Ther. 2024 Apr;13(2):465-473. doi: 10.1007/s40120-024-00586-w. Epub 2024 
      Feb 15.