CGRP monoclonal antibody use for the preventive treatment of refractory headache disorders in adolescents

Kaitlin A. Greene, Carlyn Patterson Gentile, Christina L. Szperka, Marcy Yonker, Amy A. Gelfand,Barbara Grimes, Samantha L. Irwin.  CGRP Monoclonal Antibody use for the Preventive Treatment of Refractory Headache Disorders in Adolescents.  Pediatric Neurology October 05, 2020  DOI: https://doi.org/10.1016/j.pediatrneurol.2020.09.014 

Abstract:

Background

Monoclonal antibodies (mAbs) to calcitonin gene-related peptide (CGRP) or its receptor have clinical trial evidence in adults with headache, but data are lacking in adolescents.

Objective

To describe the safety and efficacy of CGRP monoclonal antibody (mAb) treatment in adolescents with chronic headache disorders.

Methods

Retrospective multi-site cohort study of adolescents <18 years prescribed a CGRP mAb for headache prevention. Demographics, baseline headache characteristics, efficacy and side effect data was collected.

Results

n=112 adolescents received ≥1 dose of a CGRP mAb. Mean (SD; range) age at first dose was 15.9 years (1.4; 10.3 to 17.8). Ninety-four (83.9%) had chronic migraine, 12 (10.7%) had NDPH, and 6 (5.4%) had PPTH. At baseline, mean (SD) baseline headache days per month was 26.9 (6.1) (n=109) and headache was continuous in 75/111 (67.6%). At follow-up visit 1 there was a significant reduction in headache frequency compared to baseline (-2.0 days, 95% CI: -0.8 to -3.2). Significant benefit was perceived by 29.5% at follow-up visit 1 (n=33/112) and 30.1% (n=22/73) at visit 2. Significant functional improvement was perceived by 31% (n =31/94) at the 1st follow-up and 22.4% (n=15/67) at the 2nd follow-up. Most common side effects were injection site reactions in 17.0% (n=19) and constipation in 8.0% (n=9). Five patients (4.5%) discontinued due to side effects.

Conclusions

Side effects with CGRP mAb treatment in adolescents are similar to those reported in adult trials. CGRP monoclonal antibody treatment appears to benefit a proportion of adolescents with chronic refractory headache disorders

Courtesy of:  https://www.mdlinx.com/journal-summary/cgrp-monoclonal-antibody-use-for-the-preventive-treatment-of-refractory-headache-disorders-in/13F4pA17zrii3L00uViXJh