ArticleCephalalgia : an international journal of headache2022
Detoxification vs non-detoxification before starting an anti-CGRP monoclonal antibody in medication overuse headache.
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. Cited by 18 papers, 2 of them syntheses that pooled it.
What it found
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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.
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Who cites it
18 citing papers in PubMed, 2 syntheses or guidelines pooled it, 36 citations in OpenAlex.
- 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
- Methodological considerations on real-world evidence studies of monoclonal antibodies against the CGRP-pathway for migraine: a systematic review.The journal of headache and pain · 2023Pooled it
- Effectiveness of atogepant in migraine with and without medication overuse: Pooled real-world analysis of two independent clinical cohorts.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026Observational
- Atogepant Reduces Psychological Dependence on Acute Treatments Evaluated With the Leeds Dependence Questionnaire: A Prospective Study.Brain and behavior · 2026Article
- Current landscape of migraine care with expert consensus from East Asia.The journal of headache and pain · 2026Review
- Deprescribing and Anti-CGRP preventive therapy in medication-overuse headache associated with migraine: pathophysiological rationale and single-center real world evidence.Frontiers in drug safety and regulation · 2026Article
- Sequential use of OnabotulinumtoxinA and Erenumab in Chronic Migraine: Retrospective Real-World Report on Bidirectional Switching.Neurology and therapy · 2025Article
- Calcitonin gene-related peptide monoclonal antibodies and medication overuse headache: is stopping excessive pain medication still necessary?Arquivos de neuro-psiquiatria · 2025Review
- Article
- Persistent effectiveness of CGRP antibody therapy in migraine and comorbid medication overuse or medication overuse headache - a retrospective real-world analysis.The journal of headache and pain · 2024Article
- CGRP-targeted medication in chronic migraine - systematic review.The journal of headache and pain · 2024Review
- Effects of Fremanezumab on Medication Overuse in Japanese Chronic Migraine Patients: Post Hoc Analysis of a Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial.Neurology and therapy · 2023Article
- Ten open questions in migraine prophylaxis with monoclonal antibodies blocking the calcitonin-gene related peptide pathway: a narrative review.The journal of headache and pain · 2023Review
- Galcanezumab for the treatment of chronic migraine and medication overuse headache: Real-world clinical evidence in a severely impaired patient population.Brain and behavior · 2023Article
- Monoclonal antibodies for chronic migraine and medication overuse headache: A real-world study.Frontiers in neurology · 2023Article
- Eptinezumab for the Prevention of Migraine: Clinical Utility, Patient Preferences and Selection - A Narrative Review.Therapeutics and clinical risk management · 2023Review
- Assessing and managing medication overuse headache in Australian clinical practice.BMJ neurology open · 2023Article
- Critical reflections on medication overuse headache in patients with migraine: An unsolved riddle in nociception.Neurobiology of pain (Cambridge, Mass.)Review
Corrections and comments
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Authors and funding
11 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMedication overuse headache significantly contributes to the chronification process and treatment refractoriness of migraine. Currently, abrupt discontinuation of the overused medication still represents the best management strategy for these patients, challenging public health system resources.
methodsIn this prospective study, chronic migraine and medication overuse headache sufferers with at least 28 days of analgesic consumption per month were included. Assessment of efficacy outcomes at three months were compared among patients who underwent in-hospital abrupt discontinuation of overused acute medication (YES-DETOX group) and patients who did not (NO-DETOX group) before starting an anti-CGRP monoclonal antibody.
resultsOf 401 patients who received either erenumab or galcanezumab, 28% (n = 111) satisfied inclusion criteria (YES-DETOX n = 28; NO-DETOX n = 83). After three months of treatment, 59% (n = 65; 47/83 YES-DETOX; 18/28 NO-DETOX) patients reverted from medication overuse headache and 51% (n = 57; 42/83 YES-DETOX; 15/28 NO-DEOTX) achieved ≥50% reduction in monthly headache days; yet no statistical differences were observed between the two groups (p = 0.4788 and p = 0.8393, respectively). Monthly consumption of pain medication was the only baseline prognostic factor in multivariate analysis in the overall cohort (p = 0.016).
conclusionOur results support the emerging evidence that anti-CGRP monoclonal antibodies may be effective in medication overuse headache patients irrespective of detoxification, yet further studies are needed to draw definitive conclusions.
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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.