PDF(Pubmed)
Abstract：
OBJECTIVE: The objectives of this real-life study were to analyze the reversion of chronic migraine (CM) to episodic migraine (EM) with fremanezumab, evaluate its benefit on the symptomatology, and determine the influence of possible clinical features on the reversion.
BACKGROUND: The clinical manifestations of CM have a high impact on the quality of life of patients, and monoclonal antibodies such as fremanezumab are used as prophylactic treatment.
METHODS: Diagnosed CM patients treated for at least 3 months with monthly fremanezumab were interviewed. The data to assess efficacy were before treatment and at the time of the interview: monthly headache days (MHDs), daily headache hours (DHHs), monthly symptomatic medication days (MSMDs), percentage of patients with symptomatic medication overuse (SMO), and pain intensity with the numerical rating scale (NRS) score. Possible predictors of reversion were analyzed: percentage of patients treated for at least 12 months, hypertension, diabetes mellitus, depression, anxiety, symptomatic control with non-steroidal anti-inflammatory drugs (NSAIDs), triptans or both, and amitriptyline prophylaxis.
RESULTS: A total of 54 patients were included, of whom 40 (74.1%) were converters to EM. There were significant improvements in converters compared to pre-treatment in MHDs (28.0 vs. 5.0 days), as well as on the variables DHHs, MSMDs, and SMO. The percentage of erenumab failures was significantly higher in non-converters than in converters, as was the percentage of patients with anxiety.
CONCLUSIONS: High reversion from CM to EM was achieved with fremanezumab and notable symptomatological improvement, establishing previous failure to erenumab and anxiety as possible detrimental factors for reversion.
BACKGROUND: The clinical manifestations of CM have a high impact on the quality of life of patients, and monoclonal antibodies such as fremanezumab are used as prophylactic treatment.
METHODS: Diagnosed CM patients treated for at least 3 months with monthly fremanezumab were interviewed. The data to assess efficacy were before treatment and at the time of the interview: monthly headache days (MHDs), daily headache hours (DHHs), monthly symptomatic medication days (MSMDs), percentage of patients with symptomatic medication overuse (SMO), and pain intensity with the numerical rating scale (NRS) score. Possible predictors of reversion were analyzed: percentage of patients treated for at least 12 months, hypertension, diabetes mellitus, depression, anxiety, symptomatic control with non-steroidal anti-inflammatory drugs (NSAIDs), triptans or both, and amitriptyline prophylaxis.
RESULTS: A total of 54 patients were included, of whom 40 (74.1%) were converters to EM. There were significant improvements in converters compared to pre-treatment in MHDs (28.0 vs. 5.0 days), as well as on the variables DHHs, MSMDs, and SMO. The percentage of erenumab failures was significantly higher in non-converters than in converters, as was the percentage of patients with anxiety.
CONCLUSIONS: High reversion from CM to EM was achieved with fremanezumab and notable symptomatological improvement, establishing previous failure to erenumab and anxiety as possible detrimental factors for reversion.
摘要：
目的：这项现实生活研究的目的是分析使用fremanezumab将慢性偏头痛（CM）逆转为发作性偏头痛（EM），评估其对症状学的益处，并确定可能的临床特征对逆转的影响。
背景：CM的临床表现对患者的生活质量有很大影响，和单克隆抗体如fremanezumab被用作预防性治疗。
方法：对每月接受Fremanezumab治疗至少3个月的确诊CM患者进行访谈。评估疗效的数据是在治疗前和访谈时：每月头痛天数（MHD），每日头痛小时数（DHHs），每月对症用药天数（MSMD），有症状的药物过度使用（SMO）的患者百分比，和疼痛强度用数字评定量表(NRS)评分。分析了逆转的可能预测因素：治疗至少12个月的患者百分比，高血压,糖尿病,抑郁症,焦虑,使用非甾体抗炎药（NSAIDs）进行症状控制，Triptans或两者，和阿米替林预防。
结果：共纳入54例患者，其中40人（74.1%）转化为EM。与MHD的预处理相比，转化器有显著改善（28.0vs.5.0天)，以及变量DHs，MSMD,SMO。非转换器的erenumab故障百分比明显高于转换器，焦虑患者的百分比也是如此。
结论：使用Fremanezumab可实现从CM到EM的高度逆转，并且症状明显改善，确定以前的erenumab失败和焦虑可能是逆转的有害因素。
背景：CM的临床表现对患者的生活质量有很大影响，和单克隆抗体如fremanezumab被用作预防性治疗。
方法：对每月接受Fremanezumab治疗至少3个月的确诊CM患者进行访谈。评估疗效的数据是在治疗前和访谈时：每月头痛天数（MHD），每日头痛小时数（DHHs），每月对症用药天数（MSMD），有症状的药物过度使用（SMO）的患者百分比，和疼痛强度用数字评定量表(NRS)评分。分析了逆转的可能预测因素：治疗至少12个月的患者百分比，高血压,糖尿病,抑郁症,焦虑,使用非甾体抗炎药（NSAIDs）进行症状控制，Triptans或两者，和阿米替林预防。
结果：共纳入54例患者，其中40人（74.1%）转化为EM。与MHD的预处理相比，转化器有显著改善（28.0vs.5.0天)，以及变量DHs，MSMD,SMO。非转换器的erenumab故障百分比明显高于转换器，焦虑患者的百分比也是如此。
结论：使用Fremanezumab可实现从CM到EM的高度逆转，并且症状明显改善，确定以前的erenumab失败和焦虑可能是逆转的有害因素。
