Antibodies anti-CGRP in patients with fibromyalgia and resistant migraine, are they just as effective?

Abstract text (incl. figure legends and references)

QUESTION

Fibromyalgia is a frequent chronic disease and appears frequently with chronic migraine in our patient. We design this sub-study to evaluate if patients with fibromyalgia and migraine responds to antibodies anti-CGRP (a-CGRP) as well as patients without fibromyalgia.

METHODS

We present a sub-analysis of a prospective study of patients with resistant migraine treated with a-CGRP analyzing days of migraine (MHD), headache (HHD) and symptomatic treatment (MusD) as well as scales (HIT-6, MIDAS, pain catastrophizing scale, quality of life (MsQol)). We compared the response to a-CGRP at 3 ant 6 months in patients with fibromyalgia (Fi) and without it (No-Fi)

RESULTS

We included 53 patients Fi and 283 No-Fi. 78% of women and mean age of 46 years in the group no-Fi and 98% of women and mean age of 53 in the group Fi, 5 treatment failures in both groups.

In the group No-Fi before using the a-CGRP they have 22,6 HHD, 19,4 MHD and 19 MsuD. After 3 months, there is a reduction of 9,7 HHD, 7,8 MHD and 8 MsuD. After 6 months 10,7 HHD, 9,6 MHD, 8,6 MsuD. At 6 months, HIT-6 reduces 9,5 points, MIDAS 46,5 points and MsQol increases 20,5 points.

In the group Fi before they have 23,9 HHD, 19,9 MHD and 18,9 MsuD. After 3 months, there is a reduction of 8,9 HHD, 6,4 MHD and 5,8 MsuD. After 6 months 10,7 HHD, 8,7 MHD, 8,1 MsuD. At 6 months, HIT-6 reduces 8,8 points, MIDAS 63,5 points and MsQol increases 22,3 points.

30% in group Fi reported adverse events and 36% in No-Fi.

CONCLUSIONS

Patients with fibromyalgia responds to a-CGRP too, although, according with our study, the improvement seems to be more delayed compared to patients without fibromyalgia. The quality of life and the disability improve slightly more in the group with fibromyalgia than in the group without it. There is no difference in the rate of adverse events.

We consider that with these results, patients with fibromyalgia and migraine should be treated with a-CGRP as well as patients without it.