European Headache Federation guideline on the use of monoclonal antibodies targeting the calcitonin gene related peptide pathway for migraine prevention – 2022 update
Abstract 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...
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| Format: | Article |
| Language: | English |
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BMC
2022-06-01
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| Series: | The Journal of Headache and Pain |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s10194-022-01431-x |
| _version_ | 1818469502478712832 |
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| author | Simona Sacco Faisal Mohammad Amin Messoud Ashina Lars Bendtsen Christina I. Deligianni Raquel Gil-Gouveia Zaza Katsarava Antoinette MaassenVanDenBrink Paolo Martelletti Dimos-Dimitrios Mitsikostas Raffaele Ornello Uwe Reuter Margarita Sanchez-del-Rio Alexandra J. Sinclair Gisela Terwindt Derya Uluduz Jan Versijpt Christian Lampl |
| author_facet | Simona Sacco Faisal Mohammad Amin Messoud Ashina Lars Bendtsen Christina I. Deligianni Raquel Gil-Gouveia Zaza Katsarava Antoinette MaassenVanDenBrink Paolo Martelletti Dimos-Dimitrios Mitsikostas Raffaele Ornello Uwe Reuter Margarita Sanchez-del-Rio Alexandra J. Sinclair Gisela Terwindt Derya Uluduz Jan Versijpt Christian Lampl |
| author_sort | Simona Sacco |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-04-13T21:24:31Z |
| format | Article |
| id | doaj.art-ce8b83e7706d48f1935dece843842487 |
| institution | Directory Open Access Journal |
| issn | 1129-2369 1129-2377 |
| language | English |
| last_indexed | 2024-04-13T21:24:31Z |
| publishDate | 2022-06-01 |
| publisher | BMC |
| record_format | Article |
| series | The Journal of Headache and Pain |
| spelling | doaj.art-ce8b83e7706d48f1935dece8438424872022-12-22T02:29:22ZengBMCThe Journal of Headache and Pain1129-23691129-23772022-06-0123111910.1186/s10194-022-01431-xEuropean Headache Federation guideline on the use of monoclonal antibodies targeting the calcitonin gene related peptide pathway for migraine prevention – 2022 updateSimona Sacco0Faisal Mohammad Amin1Messoud Ashina2Lars Bendtsen3Christina I. Deligianni4Raquel Gil-Gouveia5Zaza Katsarava6Antoinette MaassenVanDenBrink7Paolo Martelletti8Dimos-Dimitrios Mitsikostas9Raffaele Ornello10Uwe Reuter11Margarita Sanchez-del-Rio12Alexandra J. Sinclair13Gisela Terwindt14Derya Uluduz15Jan Versijpt16Christian Lampl17Department of Biotechnological and Applied Clinical Sciences – University of L’AquilaDanish Headache Center, Department of Neurology, Rigshospitalet Glostrup, University of CopenhagenDanish Headache Center, Department of Neurology, Rigshospitalet Glostrup, University of CopenhagenDanish Headache Center, Department of Neurology, Rigshospitalet Glostrup, University of CopenhagenDanish Headache Center, Department of Neurology, Rigshospitalet Glostrup, University of CopenhagenHospital da Luz Headache Center, Neurology Department, Hospital da Luz LisboaChristian Hospital UnnaDepartment of Internal Medicine, Erasmus MC Medical CenterDepartment of Clinical and Molecular Medicine, Sapienza University1st Department of Neurology, Aeginition Hospital, School of Medicine, National and Kapodistrian University of AthensDepartment of Biotechnological and Applied Clinical Sciences – University of L’AquilaDepartment of Neurology, Charité Universitätsmedizin BerlinDepartment of Neurology, Clinica Universidad de NavarraInstitute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of BirminghamDepartment of Neurology, Leiden University Medical CenterDepartment of Neurology Istanbul Cerrahpasa Medical FacultyDepartment of Neurology, Vrije Universiteit Brussel (VUB), Universitair, Ziekenhuis Brussel (UZ Brussel)Department of Neurology, Headache Medical Center at the Konventhospital BHB LinzAbstract 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.https://doi.org/10.1186/s10194-022-01431-xMonoclonal antibodiesCalcitonin gene-related pathwayGuidelineMigrainePrevention |
| spellingShingle | Simona Sacco Faisal Mohammad Amin Messoud Ashina Lars Bendtsen Christina I. Deligianni Raquel Gil-Gouveia Zaza Katsarava Antoinette MaassenVanDenBrink Paolo Martelletti Dimos-Dimitrios Mitsikostas Raffaele Ornello Uwe Reuter Margarita Sanchez-del-Rio Alexandra J. Sinclair Gisela Terwindt Derya Uluduz Jan Versijpt Christian Lampl European Headache Federation guideline on the use of monoclonal antibodies targeting the calcitonin gene related peptide pathway for migraine prevention – 2022 update The Journal of Headache and Pain Monoclonal antibodies Calcitonin gene-related pathway Guideline Migraine Prevention |
| title | European Headache Federation guideline on the use of monoclonal antibodies targeting the calcitonin gene related peptide pathway for migraine prevention – 2022 update |
| title_full | European Headache Federation guideline on the use of monoclonal antibodies targeting the calcitonin gene related peptide pathway for migraine prevention – 2022 update |
| title_fullStr | European Headache Federation guideline on the use of monoclonal antibodies targeting the calcitonin gene related peptide pathway for migraine prevention – 2022 update |
| title_full_unstemmed | European Headache Federation guideline on the use of monoclonal antibodies targeting the calcitonin gene related peptide pathway for migraine prevention – 2022 update |
| title_short | European Headache Federation guideline on the use of monoclonal antibodies targeting the calcitonin gene related peptide pathway for migraine prevention – 2022 update |
| title_sort | european headache federation guideline on the use of monoclonal antibodies targeting the calcitonin gene related peptide pathway for migraine prevention 2022 update |
| topic | Monoclonal antibodies Calcitonin gene-related pathway Guideline Migraine Prevention |
| url | https://doi.org/10.1186/s10194-022-01431-x |
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