Key clinical point: Patients with difficult-to-treat chronic migraine and insufficient treatment response after the first 2 cycles of onabotulinumtoxinA showed improvements in migraine-related outcomes after switching to anti-calcitonin gene-related peptide monoclonal antibodies (anti-CGRP mAbs).
Major finding: At 9 months, a higher proportion of patients achieved a ≥50% response rate (65.0% vs 22.4%) and reported a greater reduction in monthly headache days (change from baseline −12.0 vs −5.0 days) with anti-CGRP mAbs vs onabotulinumtoxinA treatment. No serious adverse events were reported. Treatment discontinuation due to adverse events was reported by 2 patients.
Study details: This retrospective analysis included 78 patients with difficult-to-treat chronic migraine with or without medication overuse and ≥2 migraine preventive treatment failures who discontinued onabotulinumtoxinA and switched to anti-CGRP mAbs.
Disclosures: This study did not receive any specific funding. Three authors declared receiving personal fees or grants or serving on a scientific advisory board and as a founding scientist for various sources.
Source: Iannone LF et al. Switching onabotulinumtoxinA to monoclonal anti-CGRP antibodies in drug-resistant chronic migraine. CNS Drugs. 2023;37(2):189-202 (Jan 19). Doi: 10.1007/s40263-022-00983-5