Open AccessEfficacy of Calcitonin Gene-Related Peptide Antagonists in the Treatment of Acute Migraine: A Systematic Review and Meta-analysis
Author(s) -
Kristina M. Canlas,
Regina A. Macalintal-Canlas,
Fumihiko Sakai
Publication year - 2019
Publication title -
acta medica philippina/acta medica philippina
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.128
H-Index - 4
eISSN - 2094-9278
pISSN - 0001-6071
DOI - 10.47895/amp.v53i1.223
Subject(s) - calcitonin gene related peptide , triptans , medicine , placebo , migraine , pain relief , meta analysis , anesthesia , randomized controlled trial , significant difference , gastroenterology , receptor , neuropeptide , alternative medicine , pathology
Objective. This study determined the efficacy of calcitonin gene-related peptide (CGRP) antagonists in the treatment of acute migraine.
Methods. Seven randomized, controlled trials were included. Outcome measures used were pain freedom and pain relief two hours after treatment.
Results. The difference in pain freedom 2 hours post-dose significantly favored gepants 140/150 mg (OR=2.39, 95% CI=1.93-2.96, P<0.00001) and 280/300 mg (OR=2.94, 95% CI=2.44-3.35, P<0.00001) over placebo, while the difference in pain freedom 2 hours post- dose did not significantly favor triptans over gepants 140/150 mg and vice versa (OR=0.62, 95% CI=0.32-1.21, P=0.16) and over gepants 280/300 mg (OR=0.86, 95% CI=0.64-1.15, P=0.34). The difference in pain relief 2 hours post-dose significantly favored gepants 140/150 mg (OR=2.49, 95% CI=2.13-2.91, P<0.00001) and 280/300 mg (OR=2.78, 95% CI=2.41-3.21, P<0.00001) over placebo. The difference in pain relief 2 hours post-dose significantly favored triptans over gepants 140/150 mg (OR=0.73, 95% CI=0.56-0.96, P=0.03), but not over gepants 280/300 mg and vice versa (OR=0.98, 95% CI=0.76-1.27, P=0.89).
Conclusion. With regard to pain freedom and pain relief two hours post-dose, CGRP antagonists are more efficacious than placebo in the treatment of acute migraine but there is insufficient evidence to demonstrate superior efficacy of CGRP antagonists over triptans.