The Clinical journal of pain | 2021
Quality of Life Related to Functional Disability in Migraine Patients: A Systematic Review and Network-meta Analysis.
Abstract
OBJECTIVE\nTo 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 disability related to migraine in adult patients.\n\n\nMETHODS\nMEDLINE, Embase and Cochrane Central Register of Controlled Trials searched from inception to May 2020 with an additional review of clinical trial registries. Disability evaluated using change in patient reported Migraine Disability Assessment (MIDAS) scores from baseline were considered for the final analysis. The network meta-analysis was conducted in Bayesian framework using OpenBUGS and R, with the random effects model selected to allow for apparent heterogeneity between studies in the treatment comparison effects.\n\n\nRESULTS\nOverall 41 studies (7095 migraineurs in nine randomized trials) were included with treatment course of at least 12 weeks. Subcutaneous injections of fremanezumab 675+225+225▒mg QM and 225+225+225▒QM were more effective in reducing disability in chronic and episodic migraine, respectively with higher median difference in MIDAS score from baseline compared to other treatments including erenumab (70▒mg QM; 140▒mg QM), galcanezumab (120▒mg QM; 240▒mg QM) and low doses of fremanezumab (225▒mg single dose; 675▒mg single dose).\n\n\nDISCUSSION\nFor short term prevention of migraine, fremanezumab demonstrated slightly better improvement in disability compared with other anti-CGRP mAbs in adult patients with migraine.