Detaillierte Beitrags-Information
| Beitragstitel | Use of Calcitonin Gene-Related Peptid monoclonal antibodies (CGRP-Abs) for preventive treatment in 4 adolescents with frequent episodic or chronic refractory migraine |
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| Beitragscode | P16 |
| Autor:innen | |
| Präsentationsform | Poster |
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| Abstract-Text |
Background: In adolescents the prevalence of episodic migraine varies from 9-15%, for chronic migraine it is estimated to be 1-2%. Frequent episodic and chronic migraine is often associated with significant disability and treatment resistance. In the past years monoclonal antibodies targeting to CGRP are used as first drugs to specifically influence migraine pathogenesis in the preventive treatment in adult migraineurs. The results of the ongoing RCTs with CGRP-Abs in adolescents < 18 yrs with episodic and chronic migraine are expected in a few years, and real-world-data of CGRP-Abs in adolescents are scarce. Methods: To study the efficacy and safety of the CGRP-Ab erenumab, we retrospectively collected data from four 17 years old adolescents (three female and one male) with frequent episodic (> 8 episodes/month) or chronic migraine, three of them having additional headaches of tension type. All of them received at least 3 different prophylactic medications according to international guidelines: besides nutraceuticals and additinal complementary methods (acupuncture, cefaly), propranolol, flunarizine, lamotrigine, topiramate, amitriptyline were used, but showed no significant effect on migraine frequency and burden. Because of the persistent impact of the migraine on apprenticeship or school, all patients were treated “off-label” with erenumab subcutaneously (s.c.) 70 mg every month, and in two of them the monthly dose was increased to 140 mg s.c., with a follow-up of ½-2 yrs. Results: All four patients received initially monthly 70 mg erenumab s.c. Three of them showed a significant and persistent decrease in migraine attacks, defined by a more than 50% decrease in the frequency of disabling attacks and with an increase in quality of life. One female patient with chronic migraine showed a further, significant improvement after increasing the dosage to 140 mg monthly. One male adolescent showed an increase of migraine episodes after 3 doses of 70 mg, and even after the increase of the dose to 140 mg he showed no improvement, so erenumab was discontinued after a total of 5 doses. The only adverse reaction observed in one female patient was constipation. Conclusions: Our results in 4 patients confirm the experience from only 2 published articles with “real-world data”, that CGRP-Abs seem to be an efficient and safe prophylaxis also for adolescents < 18 yrs with high impacting, refractory migraine, without significant adverse reactions. |