Methodological considerations on real-world evidence studies of monoclonal antibodies against the CGRP-pathway for migraine: a systematic review
Abstract Background Real-world data are accumulating on the effectiveness, tolerability and safety of anti-calcitonin gene-related peptide pathway monoclonal antibodies for the preventive treatment of migraine. We performed a systematic review of the methodology of prospective, observational, clinic...
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| Format: | Article |
| Language: | English |
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BMC
2023-06-01
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| Series: | The Journal of Headache and Pain |
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| Online Access: | https://doi.org/10.1186/s10194-023-01611-3 |
| _version_ | 1827916790742646784 |
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| author | Nicolas Vandenbussche Karolina Pisarek Koen Paemeleire |
| author_facet | Nicolas Vandenbussche Karolina Pisarek Koen Paemeleire |
| author_sort | Nicolas Vandenbussche |
| collection | DOAJ |
| description | Abstract Background Real-world data are accumulating on the effectiveness, tolerability and safety of anti-calcitonin gene-related peptide pathway monoclonal antibodies for the preventive treatment of migraine. We performed a systematic review of the methodology of prospective, observational, clinic-based real-world evidence studies with these drugs in both episodic and chronic migraine. Methods The objectives were to evaluate the definitions and reported outcomes used, and to perform a risk of bias assessment for each of the different studies. PubMed and EMBASE were systematically queried for relevant scientific articles. Study quality assessment of the included studies was conducted using the “National Heart, Lung and Blood Institute (NHLBI) Study Quality Assessment Tool for Before-After (Pre-Post) Studies with No Control Group”. Results Forty-six studies fitted the criteria for the systematic review and were included in the analysis. Ten studies (21.7%) defined a migraine day for the study, while only 5 studies defined a headache day for the study (10.9%). The most common primary endpoint/objective of the studies was change in monthly migraine days (n = 16, 34.8%), followed by responder rate (n = 15, 32.6%) and change in monthly headache days (n = 5, 10.9%). Eight studies (17.4%) did not define the primary endpoint/objective. Thirty-three studies were graded as “good” quality and 13 studies were graded as “fair”. Conclusion Our analysis shows rather significant heterogeneity and/or lack of predefined primary outcomes/objectives, definitions of outcomes measures and the use of longitudinal monitoring (e.g. headache diaries). Standardization of terminology, definitions and protocol procedures for real-world evidence studies of preventive treatments for migraine are recommended. Trial registration This study was registered with PROSPERO with ID CRD42022369366. |
| first_indexed | 2024-03-13T03:20:17Z |
| format | Article |
| id | doaj.art-8b05d19e437d4254b787d3fbb9b3d6eb |
| institution | Directory Open Access Journal |
| issn | 1129-2377 |
| language | English |
| last_indexed | 2024-03-13T03:20:17Z |
| publishDate | 2023-06-01 |
| publisher | BMC |
| record_format | Article |
| series | The Journal of Headache and Pain |
| spelling | doaj.art-8b05d19e437d4254b787d3fbb9b3d6eb2023-06-25T11:23:17ZengBMCThe Journal of Headache and Pain1129-23772023-06-0124111310.1186/s10194-023-01611-3Methodological considerations on real-world evidence studies of monoclonal antibodies against the CGRP-pathway for migraine: a systematic reviewNicolas Vandenbussche0Karolina Pisarek1Koen Paemeleire2Department of Neurology, Ghent University HospitalFaculty of Medicine and Health Sciences, Ghent UniversityDepartment of Neurology, Ghent University HospitalAbstract Background Real-world data are accumulating on the effectiveness, tolerability and safety of anti-calcitonin gene-related peptide pathway monoclonal antibodies for the preventive treatment of migraine. We performed a systematic review of the methodology of prospective, observational, clinic-based real-world evidence studies with these drugs in both episodic and chronic migraine. Methods The objectives were to evaluate the definitions and reported outcomes used, and to perform a risk of bias assessment for each of the different studies. PubMed and EMBASE were systematically queried for relevant scientific articles. Study quality assessment of the included studies was conducted using the “National Heart, Lung and Blood Institute (NHLBI) Study Quality Assessment Tool for Before-After (Pre-Post) Studies with No Control Group”. Results Forty-six studies fitted the criteria for the systematic review and were included in the analysis. Ten studies (21.7%) defined a migraine day for the study, while only 5 studies defined a headache day for the study (10.9%). The most common primary endpoint/objective of the studies was change in monthly migraine days (n = 16, 34.8%), followed by responder rate (n = 15, 32.6%) and change in monthly headache days (n = 5, 10.9%). Eight studies (17.4%) did not define the primary endpoint/objective. Thirty-three studies were graded as “good” quality and 13 studies were graded as “fair”. Conclusion Our analysis shows rather significant heterogeneity and/or lack of predefined primary outcomes/objectives, definitions of outcomes measures and the use of longitudinal monitoring (e.g. headache diaries). Standardization of terminology, definitions and protocol procedures for real-world evidence studies of preventive treatments for migraine are recommended. Trial registration This study was registered with PROSPERO with ID CRD42022369366.https://doi.org/10.1186/s10194-023-01611-3MethodologyMigraineCGRPReal-world evidenceClinical trials |
| spellingShingle | Nicolas Vandenbussche Karolina Pisarek Koen Paemeleire Methodological considerations on real-world evidence studies of monoclonal antibodies against the CGRP-pathway for migraine: a systematic review The Journal of Headache and Pain Methodology Migraine CGRP Real-world evidence Clinical trials |
| title | Methodological considerations on real-world evidence studies of monoclonal antibodies against the CGRP-pathway for migraine: a systematic review |
| title_full | Methodological considerations on real-world evidence studies of monoclonal antibodies against the CGRP-pathway for migraine: a systematic review |
| title_fullStr | Methodological considerations on real-world evidence studies of monoclonal antibodies against the CGRP-pathway for migraine: a systematic review |
| title_full_unstemmed | Methodological considerations on real-world evidence studies of monoclonal antibodies against the CGRP-pathway for migraine: a systematic review |
| title_short | Methodological considerations on real-world evidence studies of monoclonal antibodies against the CGRP-pathway for migraine: a systematic review |
| title_sort | methodological considerations on real world evidence studies of monoclonal antibodies against the cgrp pathway for migraine a systematic review |
| topic | Methodology Migraine CGRP Real-world evidence Clinical trials |
| url | https://doi.org/10.1186/s10194-023-01611-3 |
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