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CGRP Inhibitors and Oxidative Stress Biomarkers in Resistant Migraine: A Real-Life Study with Erenumab, Fremanezumab, and Galcanezumab

Patients with high-frequency resistant migraine and medication-overuse headache are still the main clinical challenge in tertiary headache centers. The approval of targeted antibodies against the calcitonin gene-related peptide (CGRP) and its receptor represents a powerful instrument. In this study,...

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Autores principales: De Luca, Ciro, Baldacci, Filippo, Mazzucchi, Sonia, Lombardo, Irene, Curto, Letizia, Ulivi, Martina, Chico, Lucia, Papa, Michele, Siciliano, Gabriele, Gori, Sara
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8509234/
https://www.ncbi.nlm.nih.gov/pubmed/34640604
http://dx.doi.org/10.3390/jcm10194586
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author De Luca, Ciro
Baldacci, Filippo
Mazzucchi, Sonia
Lombardo, Irene
Curto, Letizia
Ulivi, Martina
Chico, Lucia
Papa, Michele
Siciliano, Gabriele
Gori, Sara
author_facet De Luca, Ciro
Baldacci, Filippo
Mazzucchi, Sonia
Lombardo, Irene
Curto, Letizia
Ulivi, Martina
Chico, Lucia
Papa, Michele
Siciliano, Gabriele
Gori, Sara
author_sort De Luca, Ciro
collection PubMed
description Patients with high-frequency resistant migraine and medication-overuse headache are still the main clinical challenge in tertiary headache centers. The approval of targeted antibodies against the calcitonin gene-related peptide (CGRP) and its receptor represents a powerful instrument. In this study, we observed how biological and clinical features of resistant migraineurs responded to erenumab, fremanezumab, or galcanezumab. We found a reduction in advanced oxidation protein products (AOPP) as a biomarker of improved redox state after six months of treatment. We also found that treatment efficacy was precocious and maintained with high individual responder rates. In particular, seven out of ten patients achieved a reduction of 50% from the baseline at three months, which was maintained at six months, while about one out of our patients experienced a 75% reduction in headache frequency from the first month of treatment. The migraine disability assessment (MIDAS) and the associated fatigue, anxiety, and sleep quality also significantly improved. The allodynia symptom dropped from moderate/severe to mild/absent as a sign of central sensitization reduction. Our study confirmed the safety and efficacy of CGRP inhibition in real-life, high-challenging patients. Additional evidence is needed to understand the role of oxidative stress as a migraine biomarker.
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spelling pubmed-85092342021-10-13 CGRP Inhibitors and Oxidative Stress Biomarkers in Resistant Migraine: A Real-Life Study with Erenumab, Fremanezumab, and Galcanezumab De Luca, Ciro Baldacci, Filippo Mazzucchi, Sonia Lombardo, Irene Curto, Letizia Ulivi, Martina Chico, Lucia Papa, Michele Siciliano, Gabriele Gori, Sara J Clin Med Article Patients with high-frequency resistant migraine and medication-overuse headache are still the main clinical challenge in tertiary headache centers. The approval of targeted antibodies against the calcitonin gene-related peptide (CGRP) and its receptor represents a powerful instrument. In this study, we observed how biological and clinical features of resistant migraineurs responded to erenumab, fremanezumab, or galcanezumab. We found a reduction in advanced oxidation protein products (AOPP) as a biomarker of improved redox state after six months of treatment. We also found that treatment efficacy was precocious and maintained with high individual responder rates. In particular, seven out of ten patients achieved a reduction of 50% from the baseline at three months, which was maintained at six months, while about one out of our patients experienced a 75% reduction in headache frequency from the first month of treatment. The migraine disability assessment (MIDAS) and the associated fatigue, anxiety, and sleep quality also significantly improved. The allodynia symptom dropped from moderate/severe to mild/absent as a sign of central sensitization reduction. Our study confirmed the safety and efficacy of CGRP inhibition in real-life, high-challenging patients. Additional evidence is needed to understand the role of oxidative stress as a migraine biomarker. MDPI 2021-10-04 /pmc/articles/PMC8509234/ /pubmed/34640604 http://dx.doi.org/10.3390/jcm10194586 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
De Luca, Ciro
Baldacci, Filippo
Mazzucchi, Sonia
Lombardo, Irene
Curto, Letizia
Ulivi, Martina
Chico, Lucia
Papa, Michele
Siciliano, Gabriele
Gori, Sara
CGRP Inhibitors and Oxidative Stress Biomarkers in Resistant Migraine: A Real-Life Study with Erenumab, Fremanezumab, and Galcanezumab
title CGRP Inhibitors and Oxidative Stress Biomarkers in Resistant Migraine: A Real-Life Study with Erenumab, Fremanezumab, and Galcanezumab
title_full CGRP Inhibitors and Oxidative Stress Biomarkers in Resistant Migraine: A Real-Life Study with Erenumab, Fremanezumab, and Galcanezumab
title_fullStr CGRP Inhibitors and Oxidative Stress Biomarkers in Resistant Migraine: A Real-Life Study with Erenumab, Fremanezumab, and Galcanezumab
title_full_unstemmed CGRP Inhibitors and Oxidative Stress Biomarkers in Resistant Migraine: A Real-Life Study with Erenumab, Fremanezumab, and Galcanezumab
title_short CGRP Inhibitors and Oxidative Stress Biomarkers in Resistant Migraine: A Real-Life Study with Erenumab, Fremanezumab, and Galcanezumab
title_sort cgrp inhibitors and oxidative stress biomarkers in resistant migraine: a real-life study with erenumab, fremanezumab, and galcanezumab
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8509234/
https://www.ncbi.nlm.nih.gov/pubmed/34640604
http://dx.doi.org/10.3390/jcm10194586
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