10.25384/SAGE.C.6452366
Faraidoon Haghdoost
Faraidoon
Haghdoost
Francesca Puledda
Francesca
Puledda
David Garcia-Azorin
David
Garcia-Azorin
Eva-Maria Huessler
Eva-Maria
Huessler
Roberta Messina
Roberta
Messina
Patricia Pozo-Rosich
Patricia
Pozo-Rosich
Vall d'Hebron Hospital Universitari
Vall d'Hebron Institut de Recerca
Autonomous University of Barcelona
Evaluating the efficacy of CGRP mAbs and gepants for the preventive treatment of migraine: A systematic review and network meta-analysis of phase 3 randomised controlled trials
<div>Background<p>Several novel treatments targeting the calcitonin gene-related peptide pathway have been developed for migraine. We evaluated the efficacy of these medications, including atogepant, rimegepant, erenumab, eptinezumab, fremanezumab, and galcanezumab, for the prevention of migraine via network meta-analysis.</p>Methods<p>Databases, including MEDLINE via PubMed, EMBASE, and Cochrane central, were systematically reviewed, and all eligible phase 3 randomised controlled trials were included.</p>Results<p>Nineteen studies (n = 14,584 participants) were included. Studies included episodic (n = 11) and chronic (n = 4) migraine or both (n = 4). All interventions, except for eptinzumab 30<b> </b>mg, significantly reduced mean monthly migraine days compared to placebo. All medications had a higher ≥50% responder rate than placebo and results were statistically significant in those with the subcutaneous or intravenous route of administrations, but not with the oral one. All medications significantly reduced mean monthly headache days, although no data for this outcome was available for rimegepant, and mean monthly acute medication days, with no data for eptinezumab.</p>Conclusion<p>The results show that medications targeting calcitonin gene-related peptide were effective in preventing migraine compared to placebo. Considering limitations of single studies, different populations such as episodic and chronic migraine, and the absence of head-to-head trials, all novel treatments decreased mean monthly migraine and headache days, and showed higher 50%, 75% and 100% responder rates than placebo.</p><p><b>Trial registration:</b> PROSPERO registration: CRD42022310579</p></div>
110306 Endocrinology
110904 Neurology and Neuromuscular Diseases
111599 Pharmacology and Pharmaceutical Sciences not elsewhere classified
170199 Psychology not elsewhere classified
110319 Psychiatry (incl. Psychotherapy)
Neuroscience
111599 Pharmacology and Pharmaceutical Sciences not elsewhere classified
SAGE Journals
2023
2023-03-02
2023-03-02
Collection
10.1177/03331024231159366
CC BY 4.0