ArticleJournal of neurology2025
Three-year treatment with anti-CGRP monoclonal antibodies modifies migraine course: the prospective, multicenter I-GRAINE study.
Article in Journal of neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed.
- Cost-efficacy evaluation of a mindfulness-based program added to treatment as usual for the treatment of chronic migraine associated to medication overuse headache.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025Trial
- ESTELA-Study: Long-Term Effectiveness and Safety of Anti-Calcitonin Gene-Related Peptide Monoclonal Antibodies in Real-World Clinical Practice.Brain and behavior · 2026Article
- Changes in brainstem habituation during onabotulinumtoxinA treatment in chronic migraine: A prospective case-control study.Headache · 2026Article
- Treatment Persistence in Migraine Prophylaxis Comparing CGRP Monoclonal Antibodies vs. High-/Low-Evidence Conventional Oral Preventives-A Comparative Real-World Evidence Study of Depersonalized Data of the German Pain e-Registry.Journal of clinical medicine · 2026Article
- Responders and super-responders to atogepant after 24 weeks of treatment in migraine: real-world evidence from the GIANT-2 study.The journal of headache and pain · 2026Observational
- Migraine, monoclonal antibodies, and monitoring: a review of pharmacovigilance in the era of biologics.Frontiers in pharmacology · 2026Review
- Trends in the Disease Burden of Migraine Among Women of Reproductive Age (15-49 Years) in Low- and Middle-Income Countries, 1990-2023.International journal of women's health · 2026Article
- Timing of Effect Onset After Restarting Anti CGRP-(Receptor)-Monoclonal Antibodies Following a Mandatory Cessation After One year of Use-A Single Center Retrospective Cohort Study.Drug design, development and therapy · 2026Article
- Cost-utility analysis of eptinezumab for migraine prevention in Taiwan.Health economics review · 2025Article
- Long-term effectiveness of fremanezumab in episodic and chronic migraine patients in clinical routine - 24-months results from the prospective non-interventional FINESSE study.The journal of headache and pain · 2025Article
- Super- and absolute responders to anti-cgrp monoclonal antibodies in migraine: A one-year multicenter, prospective, observational study.Journal of neurology · 2025Observational
- Profiling the real-world migraine patient: public health insights from sociodemographic, lifestyle, and clinical data in the Italian National Migraine Registry (I-GRAINE).The journal of headache and pain · 2025Article
- Pharmacokinetics of Atogepant in Healthy Lactating Female Participants: Results from a Phase 1 Lactation Study.Neurology and therapy · 2025Article
- Effects of Pausing and Re-Initiating Fremanezumab After Continuous 24-Month Treatment for Preventing Difficult-To-Treat Migraine: Prospective, Multicenter, Real-World Data From the GRASP Study Group.European journal of neurology · 2025Article
- A 24-week prospective, multicenter, real-world study on eptinezumab's effectiveness and safety in migraine prevention (EMBRACE II).Journal of neurology · 2025Observational
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Authors and funding
20 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo determine whether extending anti-CGRP mAb treatment beyond 3 years influences migraine course, we analyzed migraine frequency during the first month of treatment discontinuation following three 12-month treatment cycles (Ts).
methodsThis multicenter, prospective, real-world study enrolled 212 patients with high-frequency episodic migraine (HFEM) or chronic migraine (CM) who completed three consecutive Ts of subcutaneous anti-CGRP mAbs. Discontinuation periods (D1, D2, D3) were defined as the first month after T1, T2, and T3, respectively. The primary endpoint was the ≥ 50% response rate at D3 compared to D2. Secondary endpoints included changes in monthly migraine days (MMD), monthly headache days (MHD), monthly analgesic intake (MAI), numerical rating scale (NRS), Headache Impact Test-6 (HIT-6), ≥ 50% response rate at D3 versus D1 and D2, and relapse rates to CM or medication overuse.
resultsAt D3 vs. D2, significant improvements (p < 0.001) were observed in the ≥ 50% response rate (77.8% vs. 53.8%), MMD (- 2.1 ± 1.7), MHD (- 2.9 ± 2.4), MAI (- 2.6 ± 2.4), NRS (- 0.7 ± 1.3), and HIT-6 (- 7.2 ± 5.9), with lower relapse rates to CM (2.3% vs. 18%) and medication overuse (1.3% vs. 10.1%). Compared to D1, D3 demonstrated greater benefits (p < 0.001) in MMD (- 2.6 ± 1.9), MHD (- 5.8 ± 3.3), MAI (- 4.9 ± 3.4), NRS (- 1 ± 1.6), and HIT- 6 (- 9.4 ± 7), alongside higher ≥ 50% response rates (77.8% vs. 25%) and reduced relapses to CM (2.3% vs. 67.7%) and medication overuse (1.3% vs. 34.2%). DISCUSSION: Three years of anti-CGRP mAb treatment revealed a progressive increase in the proportion of ≥ 50% responders (D1: 25%; D2: 53.8%; D3: 77.8%) and substantial reductions in migraine burden, suggesting that prolonged treatment may favorably modify migraine course.
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