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The efficacy and safety of calcitonin gene-related peptide monoclonal antibody for episodic migraine: a meta-analysis

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Abstract

Objective

This meta-analysis was performed to evaluate the efficacy and safety of monoclonal antibodies against calcitonin gene-related peptide (CGRP) for episodic migraine prevention.

Methods

MEDLINE, EMBASE, Web of Science, and the Cochrane Library were searched from inception to April 2018. Studies considered to be eligible were randomized controlled trials about efficacy and safety of calcitonin gene-related peptide monoclonal antibody for episodic migraine prevention.

Results

Eight randomized controlled trials involving 2292 patients were included. The outcomes of this meta-analysis presented that CGRP monoclonal antibodies for preventive treatment of episodic migraine significantly reduced the monthly migraine days from baseline [weighted mean difference (WMD) = − 1.52; 95%CI, − 1.92 to − 1.11; Z = 7.40; P < 0.001] and monthly acute migraine-specific medication consumption from baseline [WMD = − 1.45; 95%CI, − 2.17 to − 0.72; Z = 3.93; P < 0.001], as compared with placebo group. CGRP monoclonal antibodies for preventive treatment of episodic migraine significantly increased the ≥ 50% reduction from baseline in migraine days per month [RR = 1.54; 95%CI, 1.38 to1.71; Z = 7.88; P < 0.001]. The adverse events were similar between the CGRP monoclonal antibody group and placebo group (P = 0.998). The outcomes of subgroup analysis showed that erenumab, galcanezumab, and fremanezumab significantly reduced the monthly migraine days from baseline and increased the ≥ 50% reduction from baseline in migraine days per month. Both erenumab and fremanezumab significantly reduced from baseline.

Conclusions

Based on the results of this meta-analysis, CGRP monoclonal antibodies significantly reduced the monthly migraine days and acute migraine-specific medication. CGRP monoclonal antibodies were effective and safe for preventive treatment of episodic migraine.

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Authors and Affiliations

  1. Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, No. 11, Bei San Huan Dong Lu, Chaoyang District, Beijing, 100029, China

    Yuhan Zhu, Jing Zhao, Qingqing Han, Lei Liu & Xiaoxu Shen

  2. YEDA Hospital, Yantai, China

    Yanyan Liu

Authors
  1. Yuhan Zhu
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  2. Yanyan Liu
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  3. Jing Zhao
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  4. Qingqing Han
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  5. Lei Liu
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  6. Xiaoxu Shen
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Corresponding author

Correspondence to Xiaoxu Shen.

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This study was not registered.

Conflict of interest

The authors declare that they have no competing interests.

Additional information

Yuhan Zhu is the first author and Yanyan Liu is the co-first author.

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Zhu, Y., Liu, Y., Zhao, J. et al. The efficacy and safety of calcitonin gene-related peptide monoclonal antibody for episodic migraine: a meta-analysis. Neurol Sci 39, 2097–2106 (2018). https://doi.org/10.1007/s10072-018-3547-3

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  • DOI: https://doi.org/10.1007/s10072-018-3547-3

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