Pain and Headache

Anti-Calcitonin Gene Related Peptide Antibody Therapy for Migraine

Cleveland Clinic’s Section of Headache and Facial Pain, within the Center for Neurological Restoration, is among the largest and most comprehensive centers in the world dedicated to managing and treating headache and facial pain syndromes.

Outcomes Following Treatment with CGRP Monoclonal Antibodies (N=165)

2018

CGRP = calcitonin gene-related peptide, HIT-6 = Headache Impact Test, PDI = Pain Disability Index, PHQ-9 = Patient Health Questionnaire, PROMIS = Patient Reported Outcome Measurement Information System

Treatments targeting calcitonin gene-related peptide (CGRP) were approved by the FDA in 2018 and are an innovative treatment for patients with migraine. Cleveland Clinic’s Headache Section has prescribed these treatments for nearly 2000 patients. In 2018, 165 headache patients treated with CGRP therapy were reviewed; 90% had improved Headache Impact Test™ (HIT-6™) scores¹ and Pain Disability Index (PDI) scores.² All patients had improved or stable Patient-Reported Outcomes Measurement Information System (PROMIS) pain scores³ and 94% of patients had improved or stable depression scores on the Patient Health Questionnaire (PHQ-9).⁴

References
  1. Coeytaux RR, Kaufman JS, Chao R, Mann JD, Devellis RF. Four methods of estimating the minimal important difference score were compared to establish a clinically significant change in Headache Impact Test. J Clin Epidemiol. 2006 Apr;59(4):374-380.

  2. Soer R, Reneman MF, Vroomen PC, Stegeman P, Coppes MH. Responsiveness and minimally clinically important change of the Pain Disability Index in patients with chronic back pain. Spine, 2012 Apr 15;37(8):711-715.

  3. Hays RD, Bjorner JB, Revicki DA, Spritzer KL, Cella D. Development of physical and mental health summary scores from the patient-reported outcomes measurement information system (PROMIS) global items. Qual Life Res. 2009 Sep;18(7):873-880.

  4. Löwe B, Unützer J, Callahan CM, Perkins AJ, Kroenke K. Monitoring depression treatment outcomes with the Patient Health Questionnaire-9. Med Care. 2004 Dec;42(12):1194-1201.