Locking down the CGRP pathway during the COVID-19 pandemic lockdown: the PandeMig study.

Abstract

OBJECTIVES:

The COVID-19 pandemic and the consequent lockdown came as a storm disrupting people's everyday life. This study aimed at observing whether the COVID-19 related lockdown influenced migraine frequency and disability in migraine patients on therapy with monoclonal antibodies inhibiting the CGRP pathway.

METHODS:

In this longitudinal observational cohort study, 147 consecutive patients receiving monthly administration of erenumab or galcanezumab were enrolled in four Italian headache centers. All patients filled a questionnaire concerning working and household settings, recent flu symptoms or COVID-19 diagnosis, and family loss due to COVID-19 infection. Monthly migraine days (MMDs), monthly painkiller intake (MPI), and HIT-6 disability relative to the first month of lockdown imposition (T-lock) and the month before (T-free) were also collected.

RESULTS:

From T-free to T-lock, the cohort displayed a reduction in MMDs (from 10.5 ± 7.6 to 9.8 ± 7.6, p = .024) and HIT-6 scores (from 59.3 ± 8.3 men reduced MPI more frequently than women (p = .005).

CONCLUSIONS:

Our study observed that the lockdown impact to 57.8 ± 8.8, p = .009), while MPI resulted unchanged (from 11.6 ± 11.5 to 11.1 ± 11.7; p = .114). MMDs, MPI, and HIT-6 variations from T-free to T-lock did not differ according to work settings or household. Patients beyond the first 3 months of therapy presented less often a reduction in MMDs (p = .006) and on everyday life did not affect the migraine load in patients receiving monoclonal antibodies inhibiting the CGRP pathway. Patients in the first months of therapy experienced a greater improvement according to drug pharmacokinetics, while women more frequently needed rescue medications, possibly indicating presenteeism or cephalalgophobia.

• Authors: Claudia Altamura, Sabina Cevoli, Cinzia Aurilia, Gabriella Egeo, Luisa Fofi, Paola Torelli, Nicoletta Brunelli, Giulia Pierangeli, Valentina Favoni, Adriana Fallacara, Umberto Pensato, Piero Barbanti, Fabrizio Vernieri
• Journal: Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology (Neurol Sci) Vol. 41 Issue 12 Pg. 3385-3389 (Dec 2020) ISSN: 1590-3478 [Electronic] Italy
• PMID: 33001407 (Publication Type: Journal Article, Multicenter Study, Observational Study)

Chemical References

• Antibodies, Monoclonal, Humanized
• Calcitonin Gene-Related Peptide Receptor Antagonists
• galcanezumab
• erenumab

Topics

• Adult
• Antibodies, Monoclonal, Humanized (therapeutic use)
• COVID-19
• Calcitonin Gene-Related Peptide Receptor Antagonists (therapeutic use)
• Cohort Studies
• Coronavirus Infections (prevention & control)
• Female
• Humans
• Italy (epidemiology)
• Longitudinal Studies
• Male
• Middle Aged
• Migraine Disorders (drug therapy, epidemiology)
• Pandemics (prevention & control)
• Pneumonia, Viral (prevention & control)
• Quarantine (psychology)
• Surveys and Questionnaires