Galcanezumab for the prevention of chronic migraine

• Calcitonin gene-related peptide (CGRP) is a promising target for migraine prevention
• Galcanezumab is a humanized monoclonal antibody that selectively binds to and blocks the physiologic activity of CGRP
• patients with episodic migraine treated with galcanezumab had a significantly greater mean reduction in the number of monthly migraine headache days (MHDs) and low rates of treatment discontinuation compared with those treated with placebo

Galcanezumab is recommended as an option for preventing migraine in adults, only if:

• they have 4 or more migraine days a month
• at least 3 preventive drug treatments have failed and
• the company provides it according to the commercial arrangement

Stop galcanezumab after 12 weeks of treatment if:

• in episodic migraine (less than 15 headache days a month) the frequency does not reduce by at least 50%
• in chronic migraine (15 headache days a month or more with at least 8 of those having features of migraine) the frequency does not reduce by at least 30%.

Reference:

• Detke HC et al.Galcanezumab in chronic migraine - the randomized, double-blind, placebo-controlled REGAIN study .Neurology. 2018 Dec 11; 91(24): e2211–e2221.
• NICE (November 2020). Galcanezumab for preventing migraine.