• Armin Scheffler, Hannah Schenk, Sebastian Wurthmann, Michael Nsaka, Christoph Kleinschnitz, Martin Glas, and Dagny Holle.
• Department of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), West German Headache Center, University Hospital Essen, University Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany. armin.scheffler@uk-essen.de.
• J Headache Pain. 2021 Sep 20; 22 (1): 111.

BackgroundCalcitonin gene-related peptide (CGRP) (receptor) antibodies (erenumab, fremanezumab and galcanezumab) are increasingly used in prophylactic treatment of migraine. In the approval studies, severely affected patients with migraine and chronic daily headache without any headache free days were excluded. Thus, less is known about the effectiveness of CGRP antibody treatment in this cohort.MethodsClinical routine data of 32 patients with migraine and daily headache were analysed after three months of treatment with a CGRP antibody (16 erenumab, 7 galcanezumab, 9 fremanezumab), including changes of monthly headache days (MHD) monthly migraine days (MMD) and monthly acute medication intake (AMD) as well as migraine characteristics. Statistical analysis was performed with the Wilcoxon-Test. Migraine characteristics were analysed descriptively.ResultsThe number of MHD was significantly reduced (mean reduction (standard error), p-value): (-4.2 (1.3), p = 0.009) as well as MMD (-4.3 (1.6), p = 0.033). Four patients (13 %) reached a 50 % reduction regarding MHD and 8 patients (25 %) regarding MMD, migraine duration and intensity improved under therapy.ConclusionsDespite the low responder rate, CGRP antibodies can be effective at least in a few cases of severely affected patients with drug resistant migraine and chronic daily headache.Trial RegistrationRetrospective registered.© 2021. The Author(s).

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