Biological therapy of migraine: can patients who do not respond to the first anti-CGRP antibody be helped by changing treatment? Case reports from the Headache Center in Thomayer University Hospital, Prague
Abstract
Currently, biological therapy of migraine with antibodies against the CGRP receptor or CGRP ligand is available for patients in whom prophylactic treatment with standard methods has failed. Biological therapy is very effective, with most patients experiencing pain relief and substantial improvement in the quality of life.
In some cases, however, there is either no improvement at all or it is not sufficient for further reimbursement of this treatment, and the drug is no longer provided. Then, the question often arises as to how to proceed with treatment, what to do when the most up-to-date treatment has failed.
Theoretically, it could be assumed that if receptor blockade had no effect, blocking the ligand could be of benefit, i.e. switching from one drug to another. This procedure has been tested in 15 patients at our Thomayer University Hospital centre.
As an example, case reports of our three female patients are presented. The article is concluded with the current opinion of the Czech State Institute for Drug Control (SUKL) on this issue.