背景:靶向降钙素基因相关肽(CGRP)途径的单克隆抗体(mAb)在偏头痛预防中显示出良好的功效。然而,部分患者对首次mAb治疗无反应,并在可用的mAb之间切换.这项研究的目的是表征用抗CGRP(-受体,-R)单克隆抗体,并描述那些没有改变的人的头痛负担,切换一次,换了两次。
方法:这项研究使用了来自NeuroTransData队列的真实世界数据,在德国门诊神经科诊所接受治疗的偏头痛患者登记。包括已经接受至少一种抗CGRP(-R)mAb的患者。在基线和治疗期间收集头痛日记,以及每三个月的生活质量指标。总结了未转换的患者亚组以及具有一个和两个转换的患者亚组的结果。
结果:在655名符合条件的患者中,479没有切换,135切换一次,35两次,6次或更多次。每月偏头痛天数≥50%的缓解率为64.7%,50.7%,无开关为25.0%,一个开关,和最后一个治疗周期的两个开关组,分别。无开关和一个开关组的生活质量措施得到改善,但不适用于两个交换机组。
结论:在治疗过程中在抗CGRP(-R)mAb之间转换的患者仍然总体受益,但程度低于未转换的患者。与不切换和一个切换亚组相比,切换两次的患者的治疗反应明显较低。
BACKGROUND: Monoclonal antibodies (mAbs) targeting the calcitonin gene-related peptide (CGRP) pathway have shown good efficacy in migraine prophylaxis. However, a subset of patients does not respond to the first mAb treatment and switches among the available mAbs. The goal of this study is to characterize the switching pattern of migraine patients treated with anti-CGRP(-receptor, -R) mAbs, and to describe the headache burden of those who did not switch, switched once, and switched twice.
METHODS: This study used real world data from the NeuroTransData Cohort, a registry of migraine patients treated at outpatient neurology clinics across Germany. Patients who had received at least one anti-CGRP(-R) mAb were included. Headache diaries were collected at baseline and during treatment, along with quality of life measures every three months. Results were summarized for the subgroups of patients who did not switch and those with one and two switches.
RESULTS: Of the 655 eligible patients, 479 did not switch, 135 switched once, 35 twice, and 6 three or more times. The ≥ 50% response rates for monthly migraine days were 64.7%, 50.7%, and 25.0% for the no switch, one switch, and two switches groups in their last treatment cycles, respectively. Quality of life measures improved for the no switch and one switch groups, but not for the two switches group.
CONCLUSIONS: Patients who switched among anti-CGRP(-R) mAbs during the course of their treatment still benefited overall but to a lesser extent than those who did not switch. Treatment response in patients who switched twice was markedly lower compared to the no switch and one switch subgroup.