Anticuerpos monoclonales como tratamiento profiláctico en migraña refractaria. Revisión Bibliográfica

Abstract

Background: Migraine is the most common form of headache and the main cause of medical consultation; patients who have not improved after receiving two or three preventive therapy regimens suffer from refractory migraine, causing disability with a negative impact on quality of life, social and intrafamilial relationships. It has been demonstrated that calcitonin gene-related peptide (CGRP) is elevated during migraine attacks, and its pharmacological reduction translates into significant clinical improvement; monoclonal antibodies have a specific mechanism of action on the CGRP pathway, these are Eptinezumab, Fremanezumab, Galcanezumab and Erenumab. Objective: to find evidence supporting the efficacy of the use of monoclonal antibodies in the prophylactic treatment of refractory migraine. Method: a systematic search of information was performed, to identify and evaluate academic articles related to the research topic, published between 2017 and 2022 in Spanish and English. Databases were used: Pubmed, Scielo, Scopus and Medscape. Results: reduction in the number of migraine days, symptomatology, polypharmacy and medication costs, improvement in quality of life with a reduction of more than 50% of MIDAS score, reduction of migraine attack progression, reduction of headache impact, all these results were sustained over time, indicating a high response rate to the use of monoclonal antibodies. Conclusions: the efficacy of monoclonal antibodies was determined by a response rate of >50%, reduction in clinical symptoms, reduction in the number of monthly migraine days, number of drugs and cost per patient, improvement in quality of life and a good safety profile due to the minimal presence of adverse effects.