The Use of Anti-CGRP Medications for Management of Intractable Chronic Daily Headaches in the Pediatric Population: Case Series and Literature Review
Abstract
Background Chronic daily headaches are the cause of significant morbidity in adolescents. Many patients with migraine show minimal response to daily preventive medications and often have significant side effects. Calcitonin gene–related peptide (CGRP) inhibitors have been found to be effective for managing migraines in the adult population. However, limited data are available for their use in pediatrics. Methods Single-center retrospective case series of all consecutive patients (<18 years) treated at the outpatient pediatric neurology clinic at Children's Hospital of Illinois/Illinois Neurological Institute between 2020 and 2023. Data extracted from the electronic medical record included demographics, comorbidities, headache characteristics, including the Headache Impact Test–6 (HIT-6) score, and Pediatric Migraine Disability Assessment (PedMIDAS) score. The study was approved by the Institutional Review Board, and informed consent from all patients was obtained. Results Details of 8 patients treated with CGRP inhibitors are provided. Median age of the cohort was 17.2 years, and 62.5% were female. The median number of 6.5 medications were tried before CGRP inhibitors. Median Headache Impact Test–6 and Pediatric Migraine Disability Assessment scores were 76 and 40, respectively, and they decreased to a median of 36 and 5, by the last reported visit of each patient. All patients responded to the therapy, with 7 of 8 responding within 3 months (50% decrease of MIDAS score).…
How strong is the evidence?
Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health. Reported size: 8 participants or records.
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