ArticleCephalalgia : an international journal of headache2022
Effect of antibody switch in non-responders to a CGRP receptor antibody treatment in migraine: A multi-center retrospective cohort study.
Article in Cephalalgia : an international journal of headache, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05785988 (Anti-Calcitonin Gene-Related Peptide), which is not on this map. Cited by 53 papers, 6 of them syntheses that pooled it.
What it found
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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.
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.
Anti-Calcitonin Gene-Related Peptide (CGRP) Monoclonal Antibody Response After Switching in the Treatment of Migraine
Who cites it
53 citing papers in PubMed, 6 syntheses or guidelines pooled it, 122 citations in OpenAlex.
- Migraine management in Saudi Arabia: An expert consensus.Neurosciences (Riyadh, Saudi Arabia) · 2025Guideline
- CROATIAN GUIDELINES FOR SPECIFIC PREVENTIVE TREATMENT OF MIGRAINE WITH MONOCLONAL ANTIBODIES TARGETING CALCITONIN GENE-RELATED PEPTIDE (CGRP) (EPTINEZUMAB, FREMANEZUMAB, AND GALCANEZUMAB) OR THE CGRP RECEPTOR (ERENUMAB).Acta clinica Croatica · 2024Guideline
- Real-world experience of galcanezumab in the prevention of migraine in Spain: a systematic literature review.Frontiers in neurology · 2024Pooled it
- Imaging the brain and vascular reactions to headache treatments: a systematic review.The journal of headache and pain · 2023Pooled it
- Pooled it
- European Headache Federation guideline on the use of monoclonal antibodies targeting the calcitonin gene related peptide pathway for migraine prevention - 2022 update.The journal of headache and pain · 2022Guideline
- Anti-CGRP receptor antibodies do not modulate trigeminal pain processing: indication for distinct mechanisms of CGRP pathway blockade.The journal of headache and pain · 2026Trial
- Trial
- Real-world effectiveness after initiating fremanezumab treatment in US patients with episodic and chronic migraine or difficult-to-treat migraine.The journal of headache and pain · 2022Trial
- Prescriber adherence to treatment guidelines for monoclonal antibodies against Calcitonin Gene-Related Peptide in migraine prophylaxis - a register-based cohort study.The journal of headache and pain · 2026Article
- Drugs for Migraine Prophylaxis.Deutsches Arzteblatt international · 2026Review
- Persistence, switching, and healthcare use after initiating calcitonin gene-related peptide inhibitors: a real-world assessment.The journal of headache and pain · 2025Article
- Disrupting Migraine Dynamics: A Narrative Review of the Consequences of Modern Anti-CGRP Monoclonal Antibody Therapies.Neurology and therapy · 2025Review
- Efficacy and Safety of Switching between Anti-CGRP Monoclonal Antibodies: A Detailed Monthly and Long-term Follow-up Study and Literature Review.Internal medicine (Tokyo, Japan) · 2025Review
- Tolerability of switch from erenumab to fremanezumab in adults with chronic migraine: a 3-month, single-center, prospective, real-world, observational study.The journal of headache and pain · 2025Observational
- Effectiveness of switching strategies in CGRP monoclonal antibody therapy for migraine: A retrospective cohort study.Headache · 2025Article
- Efficacy and continuability of 675 mg fremanezumab administration over 2 years.The journal of headache and pain · 2025Observational
- Real-World Lessons with Fremanezumab as the Third Available CGRP Monoclonal Antibody in a Third-Level Hospital: Focus on the Factors Predicting Response.Journal of clinical medicine · 2025Article
- Switching from ligand to receptor anti-calcitonin gene-related peptide (CGRP) antibodies or vice versa in non-responders: A controlled cohort study.European journal of neurology · 2025Article
- Erenumab escalation in migraine - double dose without additional benefit - a retrospective experience.Acta neurologica Belgica · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSwitching between antibody classes might be a treatment option in migraine patients who have not responded to one class of a CGRP-(receptor) monoclonal antibody (mAb), but there are no efficacy data so far. In this real-world analysis, we assessed the treatment response to a CGRP-mAb in patients that have previously failed the CGRP-receptor-mAb erenumab.
methodsWe analyzed retrospective headache diary data of 78 patients with migraine who switched between CGRP-mAbs classes at four German headache centers either due to lack of efficacy or intolerable side effects. Among these, we identified 25 patients who did not respond to erenumab after three treatment cycles (defined as <30% reduction of monthly headache days) and had complete headache documentation at least one month before and during both treatments. We assessed the ≥30% responder rate at month three after switching from erenumab to a CGRP-mAb (galcanezumab or fremanezumab) (primary endpoint). Secondary endpoints included ≥50% responder rate, monthly headache days, and monthly days with acute medication use. In an exploratory subgroup analysis patients were stratified for daily and non-daily headache.
resultsThe switch from erenumab to a CGRP-mAb led to a ≥30% response in one-third (32%) of the patients after three treatment cycles. A ≥50% response was achieved in 12% of the patients. Monthly headache days were reduced in month three compared to baseline (20.8 ± 7.1 to 17.8 ± 9.1; p = 0.009). Stratified analysis revealed that no patient with daily headache (n = 9) responded to the treatment switch, while a 30% response was achieved by 50% of patients with non-daily headache (n = 16).
conclusionOur findings demonstrate that a relevant proportion of erenumab non-responders might benefit from a treatment switch to a CGRP-mAb. Switching seems to be a promising treatment option especially in migraine patients with non-daily headache.
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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.