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Safety of anti-CGRP therapy during COVID-19 pandemic

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Using anti-CGRP monoclonal antibodies (MAbs) does not increase the risk of COVID-19, or worsen prognosis in those who get the infection, according to recently published data from the Spanish CGRP-COVID Study Group.

Of 300 patients with migraine recruited through a Spanish Society of Neurology survey, 51.7% (155/300) were treated with anti-CGRP monoclonal MAbs. Of the total cohort, 13.7% (41/300) met the criteria for confirmed or suspected COVID-19. Headache was the most frequent symptom in 82.9% of patients (34/41), and 47.1% (16/34) reported worse headache than their usual migraine.

No significant difference was found in the proportion of COVID-19 cases in  anti-CGRP MAb users compared to non-users (16.1% [25/155] vs 11% [16/145] respectively, p=0.320). In the subgroup of patients with COVID-19, there were no differences in COVID-19 symptoms except for diarrhoea (with MAbs: 28.0%; without MAbs: 68.8%, p = 0.022).

Of the patients with COVID-19, 48.8% (20/41) visited the emergency department and 12.2% (5/41) were hospitalised. No clinical differences were found between groups of patients taking or not taking anti-CGRP MAb treatment.

From the migraine standpoint, since new waves of the pandemic may be approaching, neurologists can keep prescribing anti-CGRP MAbs, reassuring migraine patients on their use in order to avoid unnecessary discontinuation, as it does not seem to be associated with an increased susceptibility to SARS-CoV-2 infection,” the study authors concluded.

 

Reference

Caronna E, Gallardo VJ, Alpuente A et al. Safety of anti-CGRP monoclonal antibodies in patients with migraine during the COVID-19 pandemic: present and future implications. Neurología 2021. Online ahead of publication. https://doi.org/10.1016/j.nrl.2021.03.003