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01-12-2022 | Migraine | Consensus Article

European Headache Federation guideline on the use of monoclonal antibodies targeting the calcitonin gene related peptide pathway for migraine prevention – 2022 update

Authors: 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

Published in: The Journal of Headache and Pain | Issue 1/2022

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.

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Title: European Headache Federation guideline on the use of monoclonal antibodies targeting the calcitonin gene related peptide pathway for migraine prevention – 2022 update
Authors: 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
Publication date: 01-12-2022
Publisher: Springer Milan
Keywords: Migraine
Headache
Erenumab
Galcanezumab
Fremanezumab
Published in: The Journal of Headache and Pain / Issue 1/2022
Print ISSN: 1129-2369
Electronic ISSN: 1129-2377
DOI: https://doi.org/10.1186/s10194-022-01431-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

European Headache Federation guideline on the use of monoclonal antibodies targeting the calcitonin gene related peptide pathway for migraine prevention – 2022 update

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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