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- Title
Safety evaluation of oral calcitonin-gene–related peptide receptor antagonists in patients with acute migraine: a systematic review and meta-analysis.
- Authors
Lee, Seoyeon; Staatz, Christine E.; Han, Nayoung; Baek, In-hwan
- Abstract
Objective: Calcitonin gene-related peptide (CGRP) receptor antagonists have been suggested as novel treatments for acute migraine. This study aimed to use meta-analysis to compare the safety and tolerability of five existing oral CGRP receptor antagonists (BI44370TA, MK-3207, rimegepant, telcagepant, and ubrogepant) with that of a placebo or triptans against acute migraine. Methods: Five prominent databases were searched to identify randomized controlled trials on this topic. The primary safety outcomes of interest were any adverse events (AEs) and treatment-related adverse events (TRAEs), and secondary outcomes were individual events, namely diarrhea, dizziness, dry mouth, fatigue, nausea, paresthesia, somnolence, upper abdominal pain, and vomiting. Results: Fifteen studies met the eligibility criteria and were examined in detail. Although, compared to placebo, oral CGRP receptor antagonists significantly increased the incidence of any AEs (risk ratio [RR] = 1.15; 95% confidence interval [CI] = 1.07–1.23), there was no difference in the incidence of TRAEs (RR = 1.18; 95% CI = 1.00–1.38). Moreover, CGRP receptor antagonists were safer than triptans with respect to primary safety outcomes, such as any AEs (RR = 0.78; 95% CI = 0.63–0.98) and TRAEs (RR = 0.68; 95% CI = 0.58–0.79). Conclusion: Despite oral CGRP receptor antagonists posing a significantly higher risk of AEs when compared to placebo, CGRP receptor antagonists have a favorable safety profile compared to triptans. Our findings inform strategies to enhance safety and tolerability in the treatment of acute migraine.
- Subjects
SAFETY; RELATIVE medical risk; DRUG tolerance; META-analysis; CONFIDENCE intervals; MIGRAINE; NEUROPEPTIDES; SYSTEMATIC reviews; CALCITONIN; HEALTH outcome assessment; RISK assessment; SEROTONIN agonists; DRUG side effects; CHEMICAL inhibitors
- Publication
European Journal of Clinical Pharmacology, 2022, Vol 78, Issue 9, p1365
- ISSN
0031-6970
- Publication type
Article
- DOI
10.1007/s00228-022-03347-6