A型肉毒毒素与CGRP单克隆抗体药物治疗慢性偏头痛的研究进展

Research advances in calcitonin gene-related peptide monoclonal antibodies and botulinum toxin A for treatment of chronic migraine

以往研究表明,A型肉毒毒素可显著降低慢性偏头痛患者的头痛频率、头痛强度和头痛相关的功能障碍。近年来发现靶向降钙素基因相关肽(CGRP)通路的多个单克隆抗体也可以显著改善慢性偏头痛患者的临床转归。目前尚缺乏二者预防性治疗慢性偏头痛的对比研究。本文重点介绍A型肉毒毒素和靶向CGRP及其受体单抗[CGRP(r)mAb]治疗慢性偏头痛的疗效和安全性,及A型肉毒毒素疗效不足的患者转换为CGRP(r)单抗治疗后的转归,为临床治疗选择提供借鉴。

Previous studies have shown that botulinum toxin A can significantly reduce headache frequency and intensity and headache-related dysfunction in patients with chronic migraine.Recent evidence has discovered that multiple monoclonal antibodies targeting the calcitonin gene-related peptide(CGRP)pathway can also significantly improve the clinical outcome of chronic migraine.Few studies have compared the preventive effects of the two treatments for chronic migraine.This review focuses on the efficacy and safety of botulinum toxin A and monoclonal antibodies against CGRP and CGRP receptor(CGRPr)in the treatment of chronic migraine,as well as the effectiveness of CGRPr monoclonal antibodies following a poor response to botulinum toxin A,aiming to provide a reference for clinical treatment selection.