Erenumab and Possible CGRP Effect on Chronotype in Chronic Migraine: A Real-Life Study of 12 Months Treatment

Author:

Pilati Laura12,Torrente Angelo1ORCID,Di Marco Salvatore12,Ferlisi Salvatore13,Notaro Giulia1,Romano Marika1,Alonge Paolo1,Vassallo Lavinia1,Ferraù Ludovica4,Autunno Massimo5ORCID,Grugno Rosario6,Camarda Cecilia1,Brighina Filippo1

Affiliation:

1. Department of Biomedicine, Neurosciences and Advanced Diagnostics (Bi.N.D.), University of Palermo, 90127 Palermo, Italy

2. Headache Center “Casa della Salute Cittadella San Rocco”, Azienda Unità Sanitaria Locale di Ferrara, 44121 Ferrara, Italy

3. Azienda Sanitaria Locale di Collegno e Pinerolo, 10093 Collegno, Italy

4. U.O.S.D. Stroke Unit, A.O.U. “G. Martino”, 98124 Messina, Italy

5. Centro Regionale Cefalee, U.O.C. Neurologia e Malattie Neuromuscolari, A.O.U. “G. Martino”, 98124 Messina, Italy

6. U.O.C. Neurologia, I.R.C.C.S. Centro Neurolesi “Bonino Pulejo”, 98124 Messina, Italy

Abstract

The introduction of monoclonal antibodies (mAbs) directed against the calcitonin gene-related peptide (CGRP), or its receptor (CGRPr), revolutionized migraine management due to their high efficacy and few side effects. Data suggest that the CGRP may even be implicated in circadian rhythm, but studies about the effect of anti-CGRP treatments on sleep are still lacking. The aim of the present study was to assess the effect of erenumab (70 and 140 mg per month), a human mAb directed against CGRPr, on chronotype in chronic migraineurs; secondly, we assessed its efficacy, safety, and the effects on anxiety and depression. Sleep was evaluated using self-administrable questionnaires investigating chronotype, sleep quality, and daytime sleepiness. Migraine diaries and several self-administrable questionnaires regarding headache impact and psychological correlates were evaluated every 3 months during 12 months of treatment. Eighty-eight patients were included; most of them showed a significant reduction in headache frequency and an improvement in psychological symptoms. Moreover, an initial change in chronotype was observed at the three-month assessment from a morning chronotype to an intermediate one; a similar trend remained in the other evaluations, even if it did not reach a statistical significance. Lastly, patients who responded to the treatment showed a progressive sleep efficiency reduction. The present real-life study hypothesized the influence of erenumab on chronotype, representing a link between circadian rhythm, CGRP, and migraine.

Publisher

MDPI AG

Subject

General Medicine

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5. Erenumab is effective in reducing migraine frequency and improving physical functioning;Martelletti;BMJ Evid. -Based Med.,2019

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