Anti-CGRP monoclonal antibodies for chronic migraine with medication-overuse headache: a conservative meta-analysis
Abstract
Abstract Background Chronic migraine (CM) is often complicated by medication-overuse headache (MOH), worsening disability. Although withdrawal of overused medications is recommended, adherence is poor and relapse is frequent. Monoclonal antibodies (mAbs) targeting the calcitonin gene-related peptide (CGRP) pathway may offer an effective preventive option without requiring discontinuation, but current evidence is limited by few and heterogeneous randomized controlled trials (RCTs). Objective To systematically assess the efficacy and safety of anti-CGRP mAbs in treating CM with MOH (CM + MOH) under a conservative approach. Methods The PubMed, Embase, and Cochrane Central databases were searched for RCTs comparing anti-CGRP mAbs with placebo in adults with CM + MOH. The primary outcome was the mean change in monthly migraine days (MMDs) at 3 months. The secondary outcomes included acute medication use, disability, drug overuse resolution, response rate, and adverse events (AEs). Random-effects models with Sidik-Jonkman estimator and Knapp-Hartung adjustments pooled effect sizes. Results We included seven RCTs, totalling 3,094 patients. Anti-CGRP mAbs significantly reduced MMDs (mean difference [MD] = -0.35; 95%CI: -0.43 to -0.26) and acute medication use (MD = -0.35; 95%CI: -0.51 to -0.19) compared with placebo. Higher rates, of ≥ 50%, of response (risk ratio [RR] = 1.94; 95%CI: 1.60–2.34) and drug overuse resolution (RR = 1.38; 95%CI: 1.04–1.83) were observed, with no…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 3,094 participants or records.
Read the paper
Related studies
- Calcium Ions in the Physiology and Pathology of the Central Nervous System
- AI-powered in silico twins: redefining precision medicine through simulation, personalization, and predictive healthcare
- In silico functional, structural and pathogenicity analysis of missense single nucleotide polymorphisms in human MCM6 gene
- In Silico drug repurposing pipeline using deep learning and structure based approaches in epilepsy
- Targeting serotonin receptors with phytochemicals – an in-silico study
- In silico exploration of anti-prostate cancer compounds from differential expressed genes
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.