Evidence map›Paper›PMID 30651064›Full record

GuidelineThe journal of headache and pain2019

European headache federation guideline on the use of monoclonal antibodies acting on the calcitonin gene related peptide or its receptor for migraine prevention.

Simona Sacco, Lars Bendtsen, Messoud Ashina, Uwe Reuter, Gisela Terwindt, Dimos-Dimitrios Mitsikostas, Paolo Martelletti

Erratum issued Registry-linked trialOpen access · goldAbstract readPractice GuidelineSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Guideline in The journal of headache and pain, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT07103694 (Italian Real-life Multicenter Observational Study on Efficacy, Tolerability, and Safety of Innovative Drugs), which is not on this map. Cited by 176 papers, 14 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
176citing papers in PubMed, 14 pooled it
44.9field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07103694 recruitingnot on this mapstarted 2022, after this paper: background citation

Italian Real-life Multicenter Observational Study on Efficacy, Tolerability, and Safety of Innovative Drugs (Monoclonal Antibodies, Gepants, Ditans, Sumatriptan-naproxen) for Preventive or Acute Migraine Treatment.

Typeobservational_patient_registrySponsorIRCCS San Raffaele RomaRan2022 to 2026Enrolled2,641ConditionsEpisodic Migraine, Chronic Migraine, Medication Overuse HeadacheArmsanti-CGRP monoclonal antibodies, gepants, combination of sumatriptan and naproxen, ditan
3 · Its place in the literature

Who cites it

176 citing papers in PubMed, 14 syntheses or guidelines pooled it, 384 citations in OpenAlex.

  1. Guideline
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  3. Migraine management in Saudi Arabia: An expert consensus.Neurosciences (Riyadh, Saudi Arabia) · 2025
    Guideline
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  8. Guideline
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116 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 6 institutions in 5 countries.

Simona SaccoNeuroscience Section, Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, via Vetoio, 67100, L'Aquila, Italy. simona.sacco@univaq.it.ORCID http://orcid.org/0000-0003-0651-1939
Lars BendtsenDepartment of Neurology, Danish Headache Center, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Messoud AshinaDepartment of Neurology, Danish Headache Center, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Uwe ReuterDepartment of Neurology, Charité Universitätsmedizin Berlin, Berlin, Germany.
Gisela TerwindtDepartment of Neurology, Leiden University Medical Center, Leiden, The Netherlands.
Dimos-Dimitrios Mitsikostas1st Department of Neurology, National and Kapodistrian University of Athens, Athens, Greece.
Paolo MartellettiDepartment of Clinical and Molecular Medicine, Sapienza University, Rome, Italy.
University of Copenhagen · DKCharité - Universitätsmedizin Berlin · DELeiden University Medical Center · NLNational and Kapodistrian University of Athens · GRSapienza University of Rome · ITUniversity of L'Aquila · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

aimMonoclonal antibodies acting on the calcitonin gene-related peptide or on its receptor are new drugs to prevent migraine. Four monoclonal antibodies have been developed: one targeting the calcitonin gene-related peptide receptor (erenumab) and three targeting the calcitonin gene-related peptide (eptinezumab, fremanezumab, and galcanezumab). The aim of this document by the European Headache Federation (EHF) is to provide an evidence-based and expert-based guideline on the use of the monoclonal antibodies acting on the calcitonin gene-related peptide for migraine prevention.

methodsThe guideline was developed following the Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) approach. The working group identified relevant questions, performed systematic review and analysis of the literature, assessed the quality of available evidence, and wrote recommendations. Where the GRADE approach was not applicable, expert opinion was provided.

resultsWe found low to high quality of evidence to recommend eptinezumab, erenumab, fremanezumab, and galcanezumab in patients with episodic migraine and medium to high quality of evidence to recommend erenumab, fremanezumab, and galcanezumab in patients with chronic migraine. For several clinical questions, there was not enough evidence to provide recommendations using the GRADE approach and recommendations relied on experts' opinion.

conclusionMonoclonal antibodies acting on the calcitonin gene-related peptide are new drugs which can be recommended for migraine prevention. Real life data will be useful to improve the use of those drugs in clinical practice.

Indexed as

Antibodies, MonoclonalAntibodies, Monoclonal, HumanizedCalcitonin Gene-Related PeptideCalcitonin Gene-Related Peptide Receptor AntagonistsHeadacheHumansMigraine DisordersAntibodies, MonoclonalAntibodies, Monoclonal, HumanizedCalcitonin Gene-Related PeptideCalcitonin Gene-Related Peptide Receptor AntagonistseptinezumaberenumabfremanezumabgalcanezumabCalcitonin gene-related peptideChronic migraineEptinezumabErenumabFremanezumabGalcazenumabMigrainePrevention

Identifiers

PMID30651064
PMCPMC6734227
OpenAlexW2922174162

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.