Conversion from chronic to episodic migraine in patients treated with galcanezumab in real life in Italy: the 12-month observational, longitudinal, cohort multicenter GARLIT experience

J Neurol. 2022 Nov;269(11):5848-5857. doi: 10.1007/s00415-022-11226-4. Epub 2022 Jun 28.

Abstract

Objective: To investigate in real-life the conversion from chronic migraine (CM) to episodic migraine (EM), specifically to EM with High-Frequency (HFEM: 8-14 monthly migraine days, MMDs), Medium-Frequency (MFEM, 4-7 MMDs), and Low-Frequency EM (LFEM, 0-3 MMDs), and its persistence during 1 year of treatment with galcanezumab.

Methods: Consecutive CM patients treated with galcanezumab completing 1 year of observation were enrolled. We collected data on MMDs, pain intensity (Numeric Rating Scale, NRS score), and monthly acute medication intake (MAMI) from baseline (V1) to the 12-month visit (V12).

Results: Of the 155 enrolled patients, 116 (around 75%) reverted to EM at every visit and 81 (52.3%) for the entire 1-year treatment. Patients with older onset age (p = 0.010) and fewer baseline MMDs (p = 0.005) reverted more frequently to EM. At V12, 83 participants (53.5%) presented MFEM or LFEM. Patients reverted to MFEM or LFEM for 7 months (25th 1, 75th 11). The medication overuse discontinuation rate at V12 was 82.8% and occurred for 11 months (25th 8, 75th 12). From baseline to V12, the MAMI decreased by 17 symptomatic drugs (p < 0.000001) while the NRS score reduced by almost 2 points (p < 0.000001). A consistent transition to EM for the entire treatment year was observed in 81 (52.3%) patients.

Discussion: The 1-year GARLIT experience suggests that more than half of CM patients treated with galcanezumab persistently reverted to EM in real life.

Trial registration: ClinicalTrials.gov NCT04803513.

Keywords: Calcitonin gene-related peptide; Chronic migraine; Conversion; Migraine treatment; Monoclonal antibodies; Real world.

Publication types

  • Multicenter Study

MeSH terms

  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Cohort Studies
  • Double-Blind Method
  • Humans
  • Migraine Disorders* / drug therapy
  • Treatment Outcome

Substances

  • Antibodies, Monoclonal, Humanized
  • galcanezumab

Associated data

  • ClinicalTrials.gov/NCT04803513