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Constipation as a possible predictor of poor treatment response in chronic migraine : A retrospective study of anti-calcitonin gene-related peptide (anti-CGRP) monoclonal antibodies and the impact of switching

Uzun, Sena LU orcid ; Frejvall, Ulf ; Petersson, Per LU orcid and Sahin, Gürdal LU orcid (2024) In Cephalalgia Reports 7.
Abstract

Background: There is a growing awareness of constipation being a side effect of anti-calcitonin gene-related peptide (anti-CGRP) monoclonal antibodies (mAbs). This study aims to assess constipation as a side effect and explore its potential role as a predictor of treatment response in chronic migraine (CM) patients treated with anti-CGRP mAbs. Methods: We conducted a retrospective analysis of patients with CM treated with anti-CGRP mAbs between January 2019 and December 2022 at a single center. Data on patient demographics, migraine characteristics, and constipation were reviewed. Results: Among 317 patients, 192 received erenumab, 94 received fremanezumab, and 31 received galcanezumab. Constipation was significantly more common with... (More)

Background: There is a growing awareness of constipation being a side effect of anti-calcitonin gene-related peptide (anti-CGRP) monoclonal antibodies (mAbs). This study aims to assess constipation as a side effect and explore its potential role as a predictor of treatment response in chronic migraine (CM) patients treated with anti-CGRP mAbs. Methods: We conducted a retrospective analysis of patients with CM treated with anti-CGRP mAbs between January 2019 and December 2022 at a single center. Data on patient demographics, migraine characteristics, and constipation were reviewed. Results: Among 317 patients, 192 received erenumab, 94 received fremanezumab, and 31 received galcanezumab. Constipation was significantly more common with erenumab (51.5%) compared to fremanezumab (4.2%) and galcanezumab (12.9%). Among erenumab patients, 24.4% switched due to constipation, while 19.2% switched due to lack/loss of effectiveness. Patients who switched treatment experienced milder symptoms (p < 0.0001) without compromising effectiveness, even when switching due to lack/loss of effectiveness (p = 0.0068). Importantly, severe constipation rates were higher in non-responders (p = 0.036). Conclusion: Constipation is a notable side effect of anti-CGRP mAbs, particularly with erenumab in CM. Side effect monitoring is consequently crucial. Our findings suggest a potential link between poor treatment response and constipation, warranting further research into the underlying mechanisms.

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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
calcitonin gene-related peptide, Erenumab, fremanezumab, galcanezumab, migraine prevention, real-world data
in
Cephalalgia Reports
volume
7
publisher
SAGE Publications
external identifiers
  • scopus:85207217498
ISSN
2515-8163
DOI
10.1177/25158163241292307
language
English
LU publication?
yes
additional info
Publisher Copyright: © The Author(s) 2024.
id
eb1cd8a6-ed5f-48e9-8814-3351d83123c8
date added to LUP
2024-12-17 12:02:19
date last changed
2025-07-02 04:07:10
@article{eb1cd8a6-ed5f-48e9-8814-3351d83123c8,
  abstract     = {{<p>Background: There is a growing awareness of constipation being a side effect of anti-calcitonin gene-related peptide (anti-CGRP) monoclonal antibodies (mAbs). This study aims to assess constipation as a side effect and explore its potential role as a predictor of treatment response in chronic migraine (CM) patients treated with anti-CGRP mAbs. Methods: We conducted a retrospective analysis of patients with CM treated with anti-CGRP mAbs between January 2019 and December 2022 at a single center. Data on patient demographics, migraine characteristics, and constipation were reviewed. Results: Among 317 patients, 192 received erenumab, 94 received fremanezumab, and 31 received galcanezumab. Constipation was significantly more common with erenumab (51.5%) compared to fremanezumab (4.2%) and galcanezumab (12.9%). Among erenumab patients, 24.4% switched due to constipation, while 19.2% switched due to lack/loss of effectiveness. Patients who switched treatment experienced milder symptoms (p &lt; 0.0001) without compromising effectiveness, even when switching due to lack/loss of effectiveness (p = 0.0068). Importantly, severe constipation rates were higher in non-responders (p = 0.036). Conclusion: Constipation is a notable side effect of anti-CGRP mAbs, particularly with erenumab in CM. Side effect monitoring is consequently crucial. Our findings suggest a potential link between poor treatment response and constipation, warranting further research into the underlying mechanisms.</p>}},
  author       = {{Uzun, Sena and Frejvall, Ulf and Petersson, Per and Sahin, Gürdal}},
  issn         = {{2515-8163}},
  keywords     = {{calcitonin gene-related peptide; Erenumab; fremanezumab; galcanezumab; migraine prevention; real-world data}},
  language     = {{eng}},
  month        = {{01}},
  publisher    = {{SAGE Publications}},
  series       = {{Cephalalgia Reports}},
  title        = {{Constipation as a possible predictor of poor treatment response in chronic migraine : A retrospective study of anti-calcitonin gene-related peptide (anti-CGRP) monoclonal antibodies and the impact of switching}},
  url          = {{http://dx.doi.org/10.1177/25158163241292307}},
  doi          = {{10.1177/25158163241292307}},
  volume       = {{7}},
  year         = {{2024}},
}