Croatian guidelines for specific preventive treatment of migraine with monoclonal antibodies targeting calcitonin gene-related peptide (CGRP) (eptinezumab, fremanezumab, and galcanezumab) or the CGRP receptor (erenumab)

Calcitonin gene-related peptide (CGRP) plays a key role in the pathophysiology of migraine, acting on CGRP receptors in the trigeminovascular system, causing neurogenic inflammation and vasodilation, and promoting nociception. Four specific monoclonal antibodies targeting CGRP are available for p...

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Main Authors: Davor Jančuljak, Damir Petravić, Darija Mahović Lakušić, Arijana Lovrenčić-Huzjan, Koraljka Bačić Baronica, Marijana Bosnar Puretić, Zlatko Hucika, Marina Titlić, Zvonimir Popović, Zoran Tomić, Maristela Stojić, Vanja Bašić Kes
Format: Article
Language:English
Published: Sestre Milosrdnice University hospital, Institute of Clinical Medical Research 2024-01-01
Series:Acta Clinica Croatica
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Online Access:https://hrcak.srce.hr/file/474344
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author Davor Jančuljak
Damir Petravić
Darija Mahović Lakušić
Arijana Lovrenčić-Huzjan
Koraljka Bačić Baronica
Marijana Bosnar Puretić
Zlatko Hucika
Marina Titlić
Zvonimir Popović
Zoran Tomić
Maristela Stojić
Vanja Bašić Kes
author_facet Davor Jančuljak
Damir Petravić
Darija Mahović Lakušić
Arijana Lovrenčić-Huzjan
Koraljka Bačić Baronica
Marijana Bosnar Puretić
Zlatko Hucika
Marina Titlić
Zvonimir Popović
Zoran Tomić
Maristela Stojić
Vanja Bašić Kes
author_sort Davor Jančuljak
collection DOAJ
description Calcitonin gene-related peptide (CGRP) plays a key role in the pathophysiology of migraine, acting on CGRP receptors in the trigeminovascular system, causing neurogenic inflammation and vasodilation, and promoting nociception. Four specific monoclonal antibodies targeting CGRP are available for prevention of episodic and chronic migraine in adults with at least four migraine days per month. The aim of these guidelines is to provide evidence-based recommendations for the use of monoclonal antibodies targeting CGRP in migraine prevention in Croatia. The questions were formulated using the Patients, Intervention, Comparison, Outcome (PICO) criteria, with evidencebased answers. To assess the quality of scientific evidence, a review of the literature available in PubMed was performed. Relevant studies were reviewed by the Expert Group of the Headache Section of the Croatian Neurological Society, and served as the basis for formulating the recommendations outlined in these guidelines. We found high quality evidence for good safety and efficacy of anti- CGRP monoclonal antibodies in the preventive treatment of episodic and chronic migraine. These medications may be considered as first-line prophylactic therapy depending on the patient’s history, concomitant diseases, and disease burden. Further real-world studies are needed to elucidate other aspects of their application.
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spelling doaj-art-362bb5aa0f10438e83ee0d2ba3336cd12025-08-20T03:11:43ZengSestre Milosrdnice University hospital, Institute of Clinical Medical ResearchActa Clinica Croatica0353-94661333-94512024-01-0163.243644910.20471/acc.2024.63.02.22Croatian guidelines for specific preventive treatment of migraine with monoclonal antibodies targeting calcitonin gene-related peptide (CGRP) (eptinezumab, fremanezumab, and galcanezumab) or the CGRP receptor (erenumab)Davor Jančuljak0Damir Petravić1Darija Mahović Lakušić2Arijana Lovrenčić-Huzjan3Koraljka Bačić Baronica4Marijana Bosnar Puretić5Zlatko Hucika6Marina Titlić7Zvonimir Popović8Zoran Tomić9Maristela Stojić10Vanja Bašić Kes11Department of Neurology, Osijek University Hospital Center, Osijek, Croatia; Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, CroatiaDepartment of Neurology, Zagreb University Hospital Center, Zagreb, Croatia; School of Medicine, University of Zagreb, Zagreb, CroatiaDepartment of Neurology, Zagreb University Hospital Center, Zagreb, Croatia; School of Medicine, University of Zagreb, Zagreb, CroatiaSchool of Medicine, University of Zagreb, Zagreb, Croatia; Department of Neurology, Sestre milosrdnice University Hospital Center, Zagreb, Croatia; School of Dental Medicine, University of Zagreb, Zagreb, Croatia; Reference Center for Headaches, Ministry of Health of the Republic of Croatia, Zagreb, CroatiaFaculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; Department of Neurology, Sveti Duh University Hospital, Zagreb, CroatiaDepartment of Neurology, Sestre milosrdnice University Hospital Center, Zagreb, Croatia; Reference Center for Headaches, Ministry of Health of the Republic of Croatia, Zagreb, Croatia; School of Medicine, Croatian Catholic University, Zagreb, Croatia; Faculty of Education and Rehabilitation Sciences, University of Zagreb, Zagreb, CroatiaDepartment of Neurology, Zabok General Hospital and Hospital for Croatian Veterans, Zabok, CroatiaDepartment of Neurology, Split University Hospital Center, Split, Croatia; School of Medicine, University of Split, Split, CroatiaDepartment of Neurology, Osijek University Hospital Center, Osijek, Croatia; Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, CroatiaDepartment of Neurology, Rijeka University Hospital Center, Rijeka, Croatia; School of Medicine, University of Rijeka, Rijeka, CroatiaDepartment of Neurology, Dubrava University Hospital, Zagreb, CroatiaFaculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; Department of Neurology, Sestre milosrdnice University Hospital Center, Zagreb, Croatia; School of Dental Medicine, University of Zagreb, Zagreb, Croatia; Reference Center for Headaches, Ministry of Health of the Republic of Croatia, Zagreb, CroatiaCalcitonin gene-related peptide (CGRP) plays a key role in the pathophysiology of migraine, acting on CGRP receptors in the trigeminovascular system, causing neurogenic inflammation and vasodilation, and promoting nociception. Four specific monoclonal antibodies targeting CGRP are available for prevention of episodic and chronic migraine in adults with at least four migraine days per month. The aim of these guidelines is to provide evidence-based recommendations for the use of monoclonal antibodies targeting CGRP in migraine prevention in Croatia. The questions were formulated using the Patients, Intervention, Comparison, Outcome (PICO) criteria, with evidencebased answers. To assess the quality of scientific evidence, a review of the literature available in PubMed was performed. Relevant studies were reviewed by the Expert Group of the Headache Section of the Croatian Neurological Society, and served as the basis for formulating the recommendations outlined in these guidelines. We found high quality evidence for good safety and efficacy of anti- CGRP monoclonal antibodies in the preventive treatment of episodic and chronic migraine. These medications may be considered as first-line prophylactic therapy depending on the patient’s history, concomitant diseases, and disease burden. Further real-world studies are needed to elucidate other aspects of their application.https://hrcak.srce.hr/file/474344Migraine - Prevention,TreatmentCalcitonin gene-related peptide (CGRP)Monoclonal antibodyGuidelinesEptinezumab, Fremanezumab, Galcanezumab, Erenumab
spellingShingle Davor Jančuljak
Damir Petravić
Darija Mahović Lakušić
Arijana Lovrenčić-Huzjan
Koraljka Bačić Baronica
Marijana Bosnar Puretić
Zlatko Hucika
Marina Titlić
Zvonimir Popović
Zoran Tomić
Maristela Stojić
Vanja Bašić Kes
Croatian guidelines for specific preventive treatment of migraine with monoclonal antibodies targeting calcitonin gene-related peptide (CGRP) (eptinezumab, fremanezumab, and galcanezumab) or the CGRP receptor (erenumab)
Acta Clinica Croatica
Migraine - Prevention,Treatment
Calcitonin gene-related peptide (CGRP)
Monoclonal antibody
Guidelines
Eptinezumab, Fremanezumab, Galcanezumab, Erenumab
title Croatian guidelines for specific preventive treatment of migraine with monoclonal antibodies targeting calcitonin gene-related peptide (CGRP) (eptinezumab, fremanezumab, and galcanezumab) or the CGRP receptor (erenumab)
title_full Croatian guidelines for specific preventive treatment of migraine with monoclonal antibodies targeting calcitonin gene-related peptide (CGRP) (eptinezumab, fremanezumab, and galcanezumab) or the CGRP receptor (erenumab)
title_fullStr Croatian guidelines for specific preventive treatment of migraine with monoclonal antibodies targeting calcitonin gene-related peptide (CGRP) (eptinezumab, fremanezumab, and galcanezumab) or the CGRP receptor (erenumab)
title_full_unstemmed Croatian guidelines for specific preventive treatment of migraine with monoclonal antibodies targeting calcitonin gene-related peptide (CGRP) (eptinezumab, fremanezumab, and galcanezumab) or the CGRP receptor (erenumab)
title_short Croatian guidelines for specific preventive treatment of migraine with monoclonal antibodies targeting calcitonin gene-related peptide (CGRP) (eptinezumab, fremanezumab, and galcanezumab) or the CGRP receptor (erenumab)
title_sort croatian guidelines for specific preventive treatment of migraine with monoclonal antibodies targeting calcitonin gene related peptide cgrp eptinezumab fremanezumab and galcanezumab or the cgrp receptor erenumab
topic Migraine - Prevention,Treatment
Calcitonin gene-related peptide (CGRP)
Monoclonal antibody
Guidelines
Eptinezumab, Fremanezumab, Galcanezumab, Erenumab
url https://hrcak.srce.hr/file/474344
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