Cross-response to CGRP monoclonal antibodies in a real-world setting: analysis of prospective data collected in the French FHU InovPain registry
Abstract
Abstract Background: Real-world data on CGRP monoclonal antibodies (mAbs) are essential to determine whether a class effect exists and to assess the benefit of switching between treatments. Available data remain limited as most studies focused exclusively on patients who failed previous CGRP mAbs and evidence regarding newer agents such as eptinezumab are still scarce. Methods: This prospective real-word study included all adult patients enrolled in the FHU InovPain registry who received intravenous eptinezumab 100 mg and after prior treatment with one or more subcutaneous CGRP mAbs, regardless of their response to previous CGRP mAbs. According to the 50% response rate (in terms of monthly migraine days) after 6 months of treatment, a descriptive analysis of switching from subcutaneous CGRP mAbs to eptinezumab was performed. Patients were classified into three subgroups: cross-effectiveness (all CGRP mAbs were effective), cross-ineffectiveness (all CGRP mAbs were ineffective), and no cross-response (different responses across CGRP mAbs). Predictors of response to CGRP mAbs were investigated by comparing patients with cross-ineffectiveness to those who responded to at least one CGRP mAb (cross-effectiveness and no cross-response), followed by multivariate logistic regression. Results: A total of 190 patients (83.7% women; mean age 52.2 ± 13.7 years) were included. The 50% responder rate to eptinezumab was 76.0% in patients who had responded to at least one previously used…
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