Abstract

EFFECT OF ANTI-CGRP MONOCLONAL ANTIBODIES ON QUALITY OF LIFE IN MIGRAINE PATIENTS: AN INDIRECT TREATMENT COMPARISON

Prashant Soni* and Evanka Chawla

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Abstract

Objective: To conduct a systematic review and network meta-analysis of all randomized trials investigating effect of anti-calcitonin gene related peptide monoclonal antibodies (anti-CGRP mAbs) on quality of life related to migraine in adult patients. Methods: MEDLINE, Embase and Cochrane Central Register of Controlled Trials searched from inception to May 2021 with an additional review of clinical trial registries. Change from baseline in patient reported Migraine-Specific Quality-of-Life Questionnaire (MSQ) and Short Form-36 (SF-36) were considered for the final analysis. The network meta-analysis was conducted in Bayesian framework using OpenBUGS and R. PROSPERO registration number CRD42020173667. Results: Overall 39 studies (7,990 migraineurs in 11 randomized trials) were included with treatment course of at least 12 weeks. Based on MSQ scores change, subcutaneous injections of fremanezumab 675+225+225 mg QM and 225+225+225 mg QM were more effective in improving quality of life compared to other treatment doses of eptinezumab, erenumab and galcanezumab. Based on SF-36 score change, eptinezumab 300 mg improved the quality of life better than its other lower dose range of 10 to 100 mg. Discussion: For short term prevention of migraine, higher doses of fremanezumab and eptinezumab demonstrated slightly better improvement in quality of life compared with other anti-CGRP mAbs in adult patients with migraine.

Keywords: Migraine, Quality of life, Network Meta-Analysis.