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Galcanezumab in migraine prevention: a systematic review and meta-analysis of randomized controlled trials.

Abstract：

Background:Galcanezumab, along with three other monoclonal antibodies targeting the calcitonin gene-related peptide (CGRP) pathway, represents the latest disease-specific and mechanism-based treatment for the prophylaxis of migraine. Galcanezumab shares data also for the prophylaxis of cluster headache. Objective:To provide a pooled safety and efficacy analysis of all phase III randomized controlled trials of galcanezumab in the preventive therapy of migraine. Methods:A computer-based literature search was conducted on MEDLINE and the US National Institutes of Health Clinical Trials Registry for phase III randomized controlled trials of galcanezumab in migraine prevention. The primary outcome was the mean change in monthly migraine days (MMDs). The proportions of patients who reported at least one adverse event (AE), at least one serious adverse event (SAE) or withdrew from the study were used as safety outcomes. Results:Two trials were included in the efficacy meta-analysis and three in the safety meta-analysis. Migraine preventive treatment with subcutaneous galcanezumab, at both 120 mg and 240 mg dosages, was associated with a significantly greater reduction in the mean number of MMDs versus placebo (120 mg, MD = -1.98, 95% CI = -2.33 to -1.63; p < 0.0001) or (240 mg, MD = -1.86, 95% CI = -2.20 to -1.53; p < 0.0001). Galcanezumab was found to be more efficacious in all key secondary outcomes as well. Regarding safety, most of the adverse events were mild to moderate, while drop-out rates and serious adverse events were low. Conclusions:Galcanezumab is an efficacious and well-tolerated preventive treatment for migraine. Larger clinical trials with longer follow-up periods need to be conducted in order to provide more safety data of the above-mentioned drug.

journal_name

Ther Adv Neurol Disord

journal_title

Therapeutic advances in neurological disorders

authors

Gklinos P,Mitsikostas DD

doi

10.1177/1756286420918088

subject

Has Abstract

pub_date

2020-04-28 00:00:00

pages

1756286420918088

eissn

1756-2856

issn

1756-2864

pii

10.1177_1756286420918088

journal_volume

pub_type

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Galcanezumab in migraine prevention: a systematic review and meta-analysis of randomized controlled trials.