Abstract Details

Title Anti-Calcitonin Gene-Related Peptide Monoclonal Antibodies in the Treatment of Patients with Concussion

Topic Headache

Presentation(s) Headache Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 134

Objective Investigate efficacy of three anti-Calcitonin Gene-Related Peptide monoclonal antibodies (anti-CGRP mAbs), fremanezumab, galcanezumab, and erenumab, among concussion patients with post-traumatic headache (PTH) with a migraine phenotype.

Background A study using monoclonal antibodies in mice with mild traumatic brain injury saw improvements in cutaneous allodynia.¹ A study from Denmark using erenumab for PTH found patients had an 83% decrease in the number of headache days. This study also demonstrated that 44% of patients had a reduction in HIT-6 score ≥5 after 9-12 weeks of treatment.²

Design/Methods Retrospective chart review of patients diagnosed with PTH (n=63) evaluated HIT-6 and the number of concussion symptom categories (headache, dizziness, attention/concentration deficit, mood and sleep disturbance) prior to initiation of anti-CGRP mAbs and after at least 3 months of treatment.

Results Preliminary data: Patients saw decreased HIT-6 scores, score pre-treatment x¯=66.30 (50-78) and score after at least 3 months of treatment x¯=63.20 (44-78). HIT-6 score reduction x¯=6.8 (1-18). Three patients did not decrease HIT-6 score. When evaluating 5 symptom categories, patients had x¯=2.72 symptoms prior to anti-CGRP mAbs treatment, and x¯=1.98 symptoms after at least 3 months on the medication. Five patients reported adverse effects (AE) (constipation, rash, pain in throat, nausea, and syncope). Four patients switched to a different anti-CGRP mAbs without AE. Eleven patients switched due to lack of efficacy. HIT-6 scores prior to any treatment were x¯=69.22 (65-78) and were x¯=66.16 (56-76) 3-months post-treatment of the anti-CGRP mAbs the patient switched to.

Conclusions Anti-CGRP mAbs preliminary data showed improved headache severity and frequency, as well as a decreased number of concussion symptoms. There was a subset of patients with a more robust response. Switching anti-CGRP mAbs was beneficial in some patients.

Authors/Disclosures
PRESENTER	No disclosure on file
Sarah A. Mangold, DO (Nationwide Children's Hospital)	Ms. Mangold has nothing to disclose.
Jennifer W. McVige, MD, F�鶹��ýӳ�� (Dent Neurological Institute)	Dr. McVige has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Abbvie. Dr. McVige has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for AbbVie. Dr. McVige has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for UCB. Dr. McVige has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Neurelis. The institution of Dr. McVige has received research support from Amgen. The institution of Dr. McVige has received research support from Eli Lily. The institution of Dr. McVige has received research support from Biohaven/Pfizer. The institution of Dr. McVige has received research support from Lundbeck. The institution of Dr. McVige has received research support from Dent Family Foundation. The institution of Dr. McVige has received research support from Abbvie. The institution of Dr. McVige has received research support from Teva. The institution of Dr. McVige has received research support from Theranica. Dr. McVige has a non-compensated relationship as a Neurology Board with UCNS that is relevant to �鶹��ýӳ�� interests or activities. Dr. McVige has a non-compensated relationship as a Board Exam Board Member with ABPN that is relevant to �鶹��ýӳ�� interests or activities.
Dylan Lis	Mr. Lis has nothing to disclose.

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