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Clinic and genetic predictors in response to erenumab

BACKGROUND AND PURPOSE: Erenumab (ERE) is the first anticalcitonin gene‐related peptide receptor monoclonal antibody approved for migraine prevention. A proportion of patients do not adequately respond to ERE. METHODS: Prospective multicenter study involving 110 migraine patients starting ERE 70 mg...

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Autores principales: Zecca, Chiara, Cargnin, Sarah, Schankin, Christoph, Giannantoni, Nadia Mariagrazia, Viana, Michele, Maraffi, Isabella, Riccitelli, Gianna Carla, Sihabdeen, Shairin, Terrazzino, Salvatore, Gobbi, Claudio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9306465/
https://www.ncbi.nlm.nih.gov/pubmed/34965002
http://dx.doi.org/10.1111/ene.15236
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author Zecca, Chiara
Cargnin, Sarah
Schankin, Christoph
Giannantoni, Nadia Mariagrazia
Viana, Michele
Maraffi, Isabella
Riccitelli, Gianna Carla
Sihabdeen, Shairin
Terrazzino, Salvatore
Gobbi, Claudio
author_facet Zecca, Chiara
Cargnin, Sarah
Schankin, Christoph
Giannantoni, Nadia Mariagrazia
Viana, Michele
Maraffi, Isabella
Riccitelli, Gianna Carla
Sihabdeen, Shairin
Terrazzino, Salvatore
Gobbi, Claudio
author_sort Zecca, Chiara
collection PubMed
description BACKGROUND AND PURPOSE: Erenumab (ERE) is the first anticalcitonin gene‐related peptide receptor monoclonal antibody approved for migraine prevention. A proportion of patients do not adequately respond to ERE. METHODS: Prospective multicenter study involving 110 migraine patients starting ERE 70 mg monthly. Baseline socio‐demographics and migraine characteristics, including mean monthly migraine days (MMDs), migraine‐related burden (MIDAS [Migraine Disability Assessment scale] and Headache Impact Test‐6), and use of abortive medications, during 3 months before and after ERE start were collected. Real‐time polymerase chain reaction was used to determine polymorphic variants of calcitonin receptor‐like receptor and receptor activity‐modifying protein‐1 genes. Logistic regression models were used to identify independent predictors for 50% responder patients (50‐RESP) and 75% responder patients (75‐RESP). RESULTS: At month 3, MMDs decreased from 17.2 to 9.2 (p < 0.0001), 59/110 (53.6%) patients were 50‐RESP, and 30/110 (27.3%) were 75‐RESP. Age at migraine onset (odds ratio [OR] [95% confidence interval (95% CI)]: 1.062 [1.008–1.120], p = 0.024), number of failed preventive medications (0.753 [0.600–0.946], p = 0.015), and MIDAS score (1.011 [1.002–1.020], p = 0.017) were associated with 75‐RESP. Among the genetic variants investigated, RAMP1 rs7590387 was found associated with a lower probability of being 75‐RESP (per G allele OR [95% CI]: 0.53 [0.29–0.99], p = 0.048]), but this association did not survive adjustment for confounding clinical variables (per G allele, 0.55 [0.28–1.10], p = 0.09]). CONCLUSIONS: In this real‐word study, treatment with ERE significantly reduced MMDs. The number of failed preventive medications, migraine burden, and age at migraine onset predicted response to ERE. Larger studies are required to confirm a possible role of RAMP1 rs7590387 as genetic predictor of ERE efficacy.
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spelling pubmed-93064652022-07-28 Clinic and genetic predictors in response to erenumab Zecca, Chiara Cargnin, Sarah Schankin, Christoph Giannantoni, Nadia Mariagrazia Viana, Michele Maraffi, Isabella Riccitelli, Gianna Carla Sihabdeen, Shairin Terrazzino, Salvatore Gobbi, Claudio Eur J Neurol Headache BACKGROUND AND PURPOSE: Erenumab (ERE) is the first anticalcitonin gene‐related peptide receptor monoclonal antibody approved for migraine prevention. A proportion of patients do not adequately respond to ERE. METHODS: Prospective multicenter study involving 110 migraine patients starting ERE 70 mg monthly. Baseline socio‐demographics and migraine characteristics, including mean monthly migraine days (MMDs), migraine‐related burden (MIDAS [Migraine Disability Assessment scale] and Headache Impact Test‐6), and use of abortive medications, during 3 months before and after ERE start were collected. Real‐time polymerase chain reaction was used to determine polymorphic variants of calcitonin receptor‐like receptor and receptor activity‐modifying protein‐1 genes. Logistic regression models were used to identify independent predictors for 50% responder patients (50‐RESP) and 75% responder patients (75‐RESP). RESULTS: At month 3, MMDs decreased from 17.2 to 9.2 (p < 0.0001), 59/110 (53.6%) patients were 50‐RESP, and 30/110 (27.3%) were 75‐RESP. Age at migraine onset (odds ratio [OR] [95% confidence interval (95% CI)]: 1.062 [1.008–1.120], p = 0.024), number of failed preventive medications (0.753 [0.600–0.946], p = 0.015), and MIDAS score (1.011 [1.002–1.020], p = 0.017) were associated with 75‐RESP. Among the genetic variants investigated, RAMP1 rs7590387 was found associated with a lower probability of being 75‐RESP (per G allele OR [95% CI]: 0.53 [0.29–0.99], p = 0.048]), but this association did not survive adjustment for confounding clinical variables (per G allele, 0.55 [0.28–1.10], p = 0.09]). CONCLUSIONS: In this real‐word study, treatment with ERE significantly reduced MMDs. The number of failed preventive medications, migraine burden, and age at migraine onset predicted response to ERE. Larger studies are required to confirm a possible role of RAMP1 rs7590387 as genetic predictor of ERE efficacy. John Wiley and Sons Inc. 2022-01-21 2022-04 /pmc/articles/PMC9306465/ /pubmed/34965002 http://dx.doi.org/10.1111/ene.15236 Text en © 2021 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Headache
Zecca, Chiara
Cargnin, Sarah
Schankin, Christoph
Giannantoni, Nadia Mariagrazia
Viana, Michele
Maraffi, Isabella
Riccitelli, Gianna Carla
Sihabdeen, Shairin
Terrazzino, Salvatore
Gobbi, Claudio
Clinic and genetic predictors in response to erenumab
title Clinic and genetic predictors in response to erenumab
title_full Clinic and genetic predictors in response to erenumab
title_fullStr Clinic and genetic predictors in response to erenumab
title_full_unstemmed Clinic and genetic predictors in response to erenumab
title_short Clinic and genetic predictors in response to erenumab
title_sort clinic and genetic predictors in response to erenumab
topic Headache
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9306465/
https://www.ncbi.nlm.nih.gov/pubmed/34965002
http://dx.doi.org/10.1111/ene.15236
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