Preprint Case Report Version 1 Preserved in Portico This version is not peer-reviewed

Fremanezumab and Non-High-Dose Galcanezumab for Comorbid Cluster Headache in Patients With Migraine: 3 Cases

Version 1 : Received: 26 January 2023 / Approved: 26 January 2023 / Online: 26 January 2023 (04:24:39 CET)

A peer-reviewed article of this Preprint also exists.

Kashiwagi, K.; Katsuki, M.; Kawamura, S.; Tachikawa, S.; Ono, A.; Koh, A. Fremanezumab and Non-High-Dose Galcanezumab for Comorbid Cluster Headache in Patients with Migraine: Three Cases. Neurol. Int. 2023, 15, 318-324. Kashiwagi, K.; Katsuki, M.; Kawamura, S.; Tachikawa, S.; Ono, A.; Koh, A. Fremanezumab and Non-High-Dose Galcanezumab for Comorbid Cluster Headache in Patients with Migraine: Three Cases. Neurol. Int. 2023, 15, 318-324.

Abstract

A new treatment option for cluster headache (CH) prevention is needed. Monoclonal antibodies (mABs) against calcitonin gene-related peptide (CGRP) ligands are used as a preventative treatment for migraine. Considering the CGRP’s role in the CH attack’s ignition and upkeep, fremanezumab and galcanezumab have been evaluated for CH preventative treatment. However, only high-dose (300 mg) galcanezumab was proven for episodic CH prevention. We herein report 3 cases of migraine and comorbid CH with previous failures of preventive treatments. The 2 cases were treated with fremanezumab and the one with non-high-dose galcanezumab. All 3 cases showed good results not only on migraine but also on CH attacks. Our report suggested the efficacy of CGRP-mABs for CH prevention. Our cases differed from the cases in the phase 3 trials of CGRP-mABs for CH prevention in the following 2 points. First, the patients had both migraine and comorbid CH. Second, the combined use of CGRP-mABs with preventative drugs for CH, such as verapamil and/or prednisolone, was performed. Future accumulation of real-world data may prove the efficacy of CGRP-mABs for CH prevention.

Keywords

anti-calcitonin gene-related peptide monoclonal antibodies; cluster headache; migraine; real-world; galcanezumab; fremanezumab; comorbidity

Subject

Medicine and Pharmacology, Neuroscience and Neurology

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