{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T06:39:41Z","timestamp":1784356781332,"version":"3.55.0"},"reference-count":17,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,2,13]],"date-time":"2022-02-13T00:00:00Z","timestamp":1644710400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and purpose<\/jats:title><jats:p>Guidelines for migraine prophylaxis suggest stopping medication after 6\u201312\u00a0months to reevaluate treatment appropriateness. The Italian Medicines Agency set a mandatory regulation to stop anti\u2010calcitonin gene related protein (CGRP) pathway monoclonal antibody (anti\u2010CGRP mAb) treatments for 3\u00a0months after 12 months of treatment. Herein, the effects of discontinuation and retreatment of anti\u2010CGRP mAbs in resistant chronic migraine patients are assessed, evaluating predictive factors of sustained response.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a monocentric prospective cohort study, enrolling 44 severe (resistant to \u22653 preventive treatments) chronic migraine patients (all with medication\u2010overuse), treated with erenumab (54.5%) or galcanezumab (45.5%) for 12 months, who discontinued treatment for 3\u00a0months and then restarted for 1\u00a0month.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, patients reported an increasing deteriorating trend during the 3\u00a0months of discontinuation. Monthly migraine days, number of analgesics, days with at least one analgesic used, a \u226550% response rate (reduction in monthly migraine days), and Migraine Disability Assessment Score and Headache Impact Test 6 total score, remained lower than baseline values, but increased compared to month 12 of treatment. All outcome measures decreased again during the month of retreatment. Patients who did not meet criteria for restarting treatment had a lower Migraine Disability Assessment Score (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.03) and Headache Impact Test 6 (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.01) score at baseline and better outcome measures during discontinuation compared to patients who restarted treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In most patients, the 3\u2010month discontinuation of anti\u2010CGRP mAbs resulted in progressive migraine deterioration that was rapidly reverted by retreatment. However, one\u2010quarter of patients who reported better quality of life indices before treatment showed a sustained benefit during discontinuation and did not need retreatment.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.15260","type":"journal-article","created":{"date-parts":[[2022,1,31]],"date-time":"2022-01-31T08:25:39Z","timestamp":1643617539000},"page":"1505-1513","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":45,"title":["Predictors of sustained response and effects of the discontinuation of anti\u2010calcitonin gene related peptide antibodies and reinitiation in resistant chronic migraine"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3598-0195","authenticated-orcid":false,"given":"Luigi Francesco","family":"Iannone","sequence":"first","affiliation":[{"name":"Section of Clinical Pharmacology and Oncology Department of Health Sciences University of Florence  Florence Italy"},{"name":"Headache Center and Clinical Pharmacology Unit Careggi University Hospital  Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davide","family":"Fattori","sequence":"additional","affiliation":[{"name":"Section of Clinical Pharmacology and Oncology Department of Health Sciences University of Florence  Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Benemei","sequence":"additional","affiliation":[{"name":"Headache Center and Clinical Pharmacology Unit Careggi University Hospital  Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Chiarugi","sequence":"additional","affiliation":[{"name":"Section of Clinical Pharmacology and Oncology Department of Health Sciences University of Florence  Florence Italy"},{"name":"Headache Center and Clinical Pharmacology Unit Careggi University Hospital  Florence 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