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Abstract Details

Single Center Experience of mAbs-CGRP Use for Migraine Prevention
Headache
Headache Posters (7:00 AM-5:00 PM)
126
mAbs-CGRP (Erenumab, Galcanezumab, and Fremanezumab) were FDA approved for migraine prevention in 2018.  Since these medications are only on the market for less than 2 years, post market data on their use and efficacy was lacking.  In this study, we present our own headache center’s experience with the use of mAbs-CGRP.
To describe the use, efficacy, and tolerability of monoclonal antibodies against calcitonin gene-related peptide (CGRP) or CGRP receptor (mAbs-CGRP) for migraine medications in our headache center.
A retrospective chart review of a single center database was conducted to find all patients initiated on a mAb-CGRP since 2018.  Information on mAb use, efficacy and tolerability were collected. Also, concomitant OnabotulinumtoxinA use was collected.
We identified 85 patients who started on mAb-CGRP.  44 (55%) had good migraine controlled on their first choice of mAb-CGRP; 33 (39%) stopped due to lack of efficacy. Of those who stopped, 31 (91%) moved onto a second mAb-CGRP.  Average time to failure (TTF) for first medication was 203 days (range 32-723 days).  21 (70%) out of 31 patients continued onto a second mAb-CGRP had their migraines well controlled; 9 (30%) stopped due to lack of efficacy. Average TTF for second medication was 247 days (range 46-529 days). 5 out of 9 patients who stopped their second mAb-CGRP were put on a third mAb-CGRP. All 5 patients’ migraines were well controlled on their third medication. 55 out of the 85 patients (65%) were also on OnabotulinumtoxinA injection regimen for migraine prevention.
70 of the 85 patients (82%) were able to tolerate use of mAbs-CGRP with some efficacy. Reasons for stopping included medication failure, adverse effects, and insurance difficulties. Combined use of mAb and OnabotulinumbtoxinA seemed to be a safe and efficacious treatment of migraine. 
Authors/Disclosures
Christopher Joseph Bondoc, MD (True North Neurology)
PRESENTER
Dr. Bondoc has nothing to disclose.
Jin Li, MD, PhD, FAAN Dr. Li has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Abbvie. Dr. Li has a non-compensated relationship as a member, woman leadership committee with AAN that is relevant to AAN interests or activities.