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.
CONCLUSIONS: Monoclonal antibodies targeting the CGRP pathway are recommended for migraine prevention as they are effective and safe also in the long-term.
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.
CONCLUSIONS: Monoclonal antibodies targeting the CGRP pathway are recommended for migraine prevention as they are effective and safe also in the long-term.
摘要：
背景：先前的欧洲头痛联合会（EHF）指南讨论了使用靶向降钙素基因相关肽（CGRP）途径的单克隆抗体预防偏头痛。从那以后,随机对照试验(RCT)和现实世界的证据扩大了这些治疗的证据和知识.因此,EHF小组决定提供关于这些治疗方法使用的最新指南.
方法：该指南是根据推荐标准制定的，评估,发展,和评估(等级)方法。工作组确定了相关问题，对文献进行了系统的回顾和分析，评估了现有证据的质量，写了建议。如果等级方法不适用，提供了专家意见。
结果：我们发现中等至高质量的证据推荐eptinezumab，erenumab,fremanezumab,和galcanezumab在发作性和慢性偏头痛患者中的应用。对于几个重要的临床问题，我们发现没有足够的证据来提供基于证据的建议和基于专家意见的指导。然而，我们提供了有关这些治疗的长期管理以及它们相对于其他偏头痛预防措施的位置的最新建议.
结论：针对CGRP途径的单克隆抗体被推荐用于偏头痛的预防，因为它们在长期内也是有效和安全的。
方法：该指南是根据推荐标准制定的，评估,发展,和评估(等级)方法。工作组确定了相关问题，对文献进行了系统的回顾和分析，评估了现有证据的质量，写了建议。如果等级方法不适用，提供了专家意见。
结果：我们发现中等至高质量的证据推荐eptinezumab，erenumab,fremanezumab,和galcanezumab在发作性和慢性偏头痛患者中的应用。对于几个重要的临床问题，我们发现没有足够的证据来提供基于证据的建议和基于专家意见的指导。然而，我们提供了有关这些治疗的长期管理以及它们相对于其他偏头痛预防措施的位置的最新建议.
结论：针对CGRP途径的单克隆抗体被推荐用于偏头痛的预防，因为它们在长期内也是有效和安全的。
