Efficacy and safety of calcitonin-gene-related peptide binding monoclonal antibodies for the preventive treatment of episodic migraine – an updated systematic review and meta-analysis
Abstract Background Migraine is one of the most common neurological disorders that leads to disabilities. However, the conventional drug therapy for migraine might be unsatisfactory at times. Therefore, this meta-analysis aimed to evaluate the efficacy and safety of calcitonin-gene-related peptide b...
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doaj-e0d543837b56477c93a941c8911719b22021-02-14T12:23:54ZengBMCBMC Neurology1471-23772020-02-0120111210.1186/s12883-020-01633-3Efficacy and safety of calcitonin-gene-related peptide binding monoclonal antibodies for the preventive treatment of episodic migraine – an updated systematic review and meta-analysisHong Deng0Gai-gai Li1Hao Nie2Yang-yang Feng3Guang-yu Guo4Wen-liang Guo5Zhou-ping Tang6Department of Neurology, Tongji Hospital, Tongji Medical college, Huazhong University of Science and TechnologyDepartment of Neurology, Tongji Hospital, Tongji Medical college, Huazhong University of Science and TechnologyDepartment of Neurology, Tongji Hospital, Tongji Medical college, Huazhong University of Science and TechnologyDepartment of Neurology, Tongji Hospital, Tongji Medical college, Huazhong University of Science and TechnologyDepartment of Neurology, Tongji Hospital, Tongji Medical college, Huazhong University of Science and TechnologyDepartment of Neurology, Tongji Hospital, Tongji Medical college, Huazhong University of Science and TechnologyDepartment of Neurology, Tongji Hospital, Tongji Medical college, Huazhong University of Science and TechnologyAbstract Background Migraine is one of the most common neurological disorders that leads to disabilities. However, the conventional drug therapy for migraine might be unsatisfactory at times. Therefore, this meta-analysis aimed to evaluate the efficacy and safety of calcitonin-gene-related peptide binding monoclonal antibody (CGRP mAb) for the preventive treatment of episodic migraine, and provide high-quality clinical evidence for migraine therapy. Methods A systematic electronic database search was conducted to identify the potentially relevant studies. Two independent authors performed data extraction and quality appraisal. Mean difference (MD) and risk ratio (RR) were pooled for continuous and dichotomous data, respectively. The significance levels, weighted effect sizes and homogeneity of variance were calculated. Results Eleven high-quality randomized control trials that collectively included 4402 patients were included in this meta-analysis. Compared to placebo group, CGRP mAb therapy resulted in a reduction of monthly migraine days [weighted mean difference (WMD) = − 1.44, 95% CI = (− 1.68,− 1.19)] and acute migraine-specific medication days [WMD = − 1.28, 95% CI = (− 1.66,− 0.90)], with an improvement in 50% responder rate [RR = 1.51, 95% CI = (1.37,1.66)]. In addition, the adverse events (AEs) and treatment withdrawal rates due to AEs were not significantly different between CGRP mAb and placebo groups. Similar efficacy and safety results were obtained for erenumab, fremanezumab, and galcanezumab in subgroup analysis. Conclusions The current body of evidence reveals that CGRP mAb is an effective and safe preventive treatment for episodic migraine.https://doi.org/10.1186/s12883-020-01633-3Calcitonin gene-related peptide monoclonal antibodyEpisodic migraineEfficacySafetyMeta-analysis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Hong Deng Gai-gai Li Hao Nie Yang-yang Feng Guang-yu Guo Wen-liang Guo Zhou-ping Tang |
spellingShingle |
Hong Deng Gai-gai Li Hao Nie Yang-yang Feng Guang-yu Guo Wen-liang Guo Zhou-ping Tang Efficacy and safety of calcitonin-gene-related peptide binding monoclonal antibodies for the preventive treatment of episodic migraine – an updated systematic review and meta-analysis BMC Neurology Calcitonin gene-related peptide monoclonal antibody Episodic migraine Efficacy Safety Meta-analysis |
author_facet |
Hong Deng Gai-gai Li Hao Nie Yang-yang Feng Guang-yu Guo Wen-liang Guo Zhou-ping Tang |
author_sort |
Hong Deng |
title |
Efficacy and safety of calcitonin-gene-related peptide binding monoclonal antibodies for the preventive treatment of episodic migraine – an updated systematic review and meta-analysis |
title_short |
Efficacy and safety of calcitonin-gene-related peptide binding monoclonal antibodies for the preventive treatment of episodic migraine – an updated systematic review and meta-analysis |
title_full |
Efficacy and safety of calcitonin-gene-related peptide binding monoclonal antibodies for the preventive treatment of episodic migraine – an updated systematic review and meta-analysis |
title_fullStr |
Efficacy and safety of calcitonin-gene-related peptide binding monoclonal antibodies for the preventive treatment of episodic migraine – an updated systematic review and meta-analysis |
title_full_unstemmed |
Efficacy and safety of calcitonin-gene-related peptide binding monoclonal antibodies for the preventive treatment of episodic migraine – an updated systematic review and meta-analysis |
title_sort |
efficacy and safety of calcitonin-gene-related peptide binding monoclonal antibodies for the preventive treatment of episodic migraine – an updated systematic review and meta-analysis |
publisher |
BMC |
series |
BMC Neurology |
issn |
1471-2377 |
publishDate |
2020-02-01 |
description |
Abstract Background Migraine is one of the most common neurological disorders that leads to disabilities. However, the conventional drug therapy for migraine might be unsatisfactory at times. Therefore, this meta-analysis aimed to evaluate the efficacy and safety of calcitonin-gene-related peptide binding monoclonal antibody (CGRP mAb) for the preventive treatment of episodic migraine, and provide high-quality clinical evidence for migraine therapy. Methods A systematic electronic database search was conducted to identify the potentially relevant studies. Two independent authors performed data extraction and quality appraisal. Mean difference (MD) and risk ratio (RR) were pooled for continuous and dichotomous data, respectively. The significance levels, weighted effect sizes and homogeneity of variance were calculated. Results Eleven high-quality randomized control trials that collectively included 4402 patients were included in this meta-analysis. Compared to placebo group, CGRP mAb therapy resulted in a reduction of monthly migraine days [weighted mean difference (WMD) = − 1.44, 95% CI = (− 1.68,− 1.19)] and acute migraine-specific medication days [WMD = − 1.28, 95% CI = (− 1.66,− 0.90)], with an improvement in 50% responder rate [RR = 1.51, 95% CI = (1.37,1.66)]. In addition, the adverse events (AEs) and treatment withdrawal rates due to AEs were not significantly different between CGRP mAb and placebo groups. Similar efficacy and safety results were obtained for erenumab, fremanezumab, and galcanezumab in subgroup analysis. Conclusions The current body of evidence reveals that CGRP mAb is an effective and safe preventive treatment for episodic migraine. |
topic |
Calcitonin gene-related peptide monoclonal antibody Episodic migraine Efficacy Safety Meta-analysis |
url |
https://doi.org/10.1186/s12883-020-01633-3 |
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