Cargando…

Change of CGRP Plasma Concentrations in Migraine after Discontinuation of CGRP-(Receptor) Monoclonal Antibodies

Discontinuation of treatment with monoclonal antibodies (mAb) targeting the Calcitonin Gene-Related Peptide (CGRP) pathway leads to an increase in migraine frequency. We aimed to assess changes in free and total CGRP plasma concentrations after the discontinuation of CGRP(-receptor) mAbs. This prosp...

Descripción completa

Detalles Bibliográficos
Autores principales: Raffaelli, Bianca, Terhart, Maria, Fitzek, Mira Pauline, Lange, Kristin Sophie, Mecklenburg, Jasper, Overeem, Lucas Hendrik, Siebert, Anke, Storch, Elisabeth, Reuter, Uwe
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9861447/
https://www.ncbi.nlm.nih.gov/pubmed/36678920
http://dx.doi.org/10.3390/pharmaceutics15010293
_version_ 1784874843816067072
author Raffaelli, Bianca
Terhart, Maria
Fitzek, Mira Pauline
Lange, Kristin Sophie
Mecklenburg, Jasper
Overeem, Lucas Hendrik
Siebert, Anke
Storch, Elisabeth
Reuter, Uwe
author_facet Raffaelli, Bianca
Terhart, Maria
Fitzek, Mira Pauline
Lange, Kristin Sophie
Mecklenburg, Jasper
Overeem, Lucas Hendrik
Siebert, Anke
Storch, Elisabeth
Reuter, Uwe
author_sort Raffaelli, Bianca
collection PubMed
description Discontinuation of treatment with monoclonal antibodies (mAb) targeting the Calcitonin Gene-Related Peptide (CGRP) pathway leads to an increase in migraine frequency. We aimed to assess changes in free and total CGRP plasma concentrations after the discontinuation of CGRP(-receptor) mAbs. This prospective analysis included 59 patients with migraine (n = 25 erenumab, n = 25 galcanezumab, n = 9 fremanezumab) who discontinued mAbs after ≥8 months of treatment. Patients were visited at the time of the last mAb injection (V1) and 16 weeks later (V2). For control, 30 migraine patients without preventive drug therapy were included. We measured free CGRP plasma concentrations in the erenumab and fremanezumab group and total CGRP concentrations in the galcanezumab group. Free CGRP plasma concentrations did not change after treatment discontinuation [erenumab: V1 31.2 pg/mL (IQR 25.8–45.6), V2 30.3 pg/mL (IQR 22.9–47.6), p = 0.65; fremanezumab V1 29.4 pg/mL (IQR 16.4–61.9), V2 34.4 (19.2–62.0), p = 0.86]. Controls had similar CGRP values of 32.6 pg/mL (IQR 21.3–44.6). Total CGRP concentrations in the galcanezumab group were 5439.3 pg/mL (2412.7–6338.1) at V1, and decreased to 1853.2 pg/mL (1136.5–3297.0) at V2 (p < 0.001). Cessation of treatment with CGRP(-R) mAbs did not have an impact on the free-circulating CGRP concentrations. Total CGRP decreased significantly after three months of treatment discontinuation.
format Online
Article
Text
id pubmed-9861447
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-98614472023-01-22 Change of CGRP Plasma Concentrations in Migraine after Discontinuation of CGRP-(Receptor) Monoclonal Antibodies Raffaelli, Bianca Terhart, Maria Fitzek, Mira Pauline Lange, Kristin Sophie Mecklenburg, Jasper Overeem, Lucas Hendrik Siebert, Anke Storch, Elisabeth Reuter, Uwe Pharmaceutics Article Discontinuation of treatment with monoclonal antibodies (mAb) targeting the Calcitonin Gene-Related Peptide (CGRP) pathway leads to an increase in migraine frequency. We aimed to assess changes in free and total CGRP plasma concentrations after the discontinuation of CGRP(-receptor) mAbs. This prospective analysis included 59 patients with migraine (n = 25 erenumab, n = 25 galcanezumab, n = 9 fremanezumab) who discontinued mAbs after ≥8 months of treatment. Patients were visited at the time of the last mAb injection (V1) and 16 weeks later (V2). For control, 30 migraine patients without preventive drug therapy were included. We measured free CGRP plasma concentrations in the erenumab and fremanezumab group and total CGRP concentrations in the galcanezumab group. Free CGRP plasma concentrations did not change after treatment discontinuation [erenumab: V1 31.2 pg/mL (IQR 25.8–45.6), V2 30.3 pg/mL (IQR 22.9–47.6), p = 0.65; fremanezumab V1 29.4 pg/mL (IQR 16.4–61.9), V2 34.4 (19.2–62.0), p = 0.86]. Controls had similar CGRP values of 32.6 pg/mL (IQR 21.3–44.6). Total CGRP concentrations in the galcanezumab group were 5439.3 pg/mL (2412.7–6338.1) at V1, and decreased to 1853.2 pg/mL (1136.5–3297.0) at V2 (p < 0.001). Cessation of treatment with CGRP(-R) mAbs did not have an impact on the free-circulating CGRP concentrations. Total CGRP decreased significantly after three months of treatment discontinuation. MDPI 2023-01-15 /pmc/articles/PMC9861447/ /pubmed/36678920 http://dx.doi.org/10.3390/pharmaceutics15010293 Text en © 2023 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
Raffaelli, Bianca
Terhart, Maria
Fitzek, Mira Pauline
Lange, Kristin Sophie
Mecklenburg, Jasper
Overeem, Lucas Hendrik
Siebert, Anke
Storch, Elisabeth
Reuter, Uwe
Change of CGRP Plasma Concentrations in Migraine after Discontinuation of CGRP-(Receptor) Monoclonal Antibodies
title Change of CGRP Plasma Concentrations in Migraine after Discontinuation of CGRP-(Receptor) Monoclonal Antibodies
title_full Change of CGRP Plasma Concentrations in Migraine after Discontinuation of CGRP-(Receptor) Monoclonal Antibodies
title_fullStr Change of CGRP Plasma Concentrations in Migraine after Discontinuation of CGRP-(Receptor) Monoclonal Antibodies
title_full_unstemmed Change of CGRP Plasma Concentrations in Migraine after Discontinuation of CGRP-(Receptor) Monoclonal Antibodies
title_short Change of CGRP Plasma Concentrations in Migraine after Discontinuation of CGRP-(Receptor) Monoclonal Antibodies
title_sort change of cgrp plasma concentrations in migraine after discontinuation of cgrp-(receptor) monoclonal antibodies
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9861447/
https://www.ncbi.nlm.nih.gov/pubmed/36678920
http://dx.doi.org/10.3390/pharmaceutics15010293
work_keys_str_mv AT raffaellibianca changeofcgrpplasmaconcentrationsinmigraineafterdiscontinuationofcgrpreceptormonoclonalantibodies
AT terhartmaria changeofcgrpplasmaconcentrationsinmigraineafterdiscontinuationofcgrpreceptormonoclonalantibodies
AT fitzekmirapauline changeofcgrpplasmaconcentrationsinmigraineafterdiscontinuationofcgrpreceptormonoclonalantibodies
AT langekristinsophie changeofcgrpplasmaconcentrationsinmigraineafterdiscontinuationofcgrpreceptormonoclonalantibodies
AT mecklenburgjasper changeofcgrpplasmaconcentrationsinmigraineafterdiscontinuationofcgrpreceptormonoclonalantibodies
AT overeemlucashendrik changeofcgrpplasmaconcentrationsinmigraineafterdiscontinuationofcgrpreceptormonoclonalantibodies
AT siebertanke changeofcgrpplasmaconcentrationsinmigraineafterdiscontinuationofcgrpreceptormonoclonalantibodies
AT storchelisabeth changeofcgrpplasmaconcentrationsinmigraineafterdiscontinuationofcgrpreceptormonoclonalantibodies
AT reuteruwe changeofcgrpplasmaconcentrationsinmigraineafterdiscontinuationofcgrpreceptormonoclonalantibodies