Locking down the CGRP pathway during the COVID-19 pandemic lockdown: the PandeMig study

Area of Science:

• Neurology
• Pharmacology

Background:

• The COVID-19 pandemic and subsequent lockdowns disrupted daily life globally.
• Migraine patients on CGRP pathway inhibitors were studied to assess lockdown's impact on their condition.

Purpose of the Study:

• To evaluate the influence of the COVID-19 lockdown on migraine frequency and disability.
• To analyze the effect on patients undergoing therapy with monoclonal antibodies targeting the CGRP pathway.

Main Methods:

• A longitudinal observational cohort study included 147 patients from four Italian headache centers.
• Data collected included monthly migraine days (MMDs), painkiller intake (MPI), and HIT-6 disability scores before and during lockdown.
• Patient demographics, work/household settings, and COVID-19 related factors were also recorded.

Main Results:

• A statistically significant reduction in MMDs (p = .024) and HIT-6 scores (p = .009) was observed during lockdown.
• Monthly painkiller intake (MPI) remained unchanged (p = .114).
• Fewer MMD reductions were noted in patients beyond the initial 3 months of therapy (p = .006), with women more frequently needing rescue medications.

Conclusions:

• The COVID-19 lockdown did not significantly alter the overall migraine burden in patients on CGRP pathway inhibitor therapy.
• Patients in the early stages of therapy showed greater improvement, potentially linked to drug pharmacokinetics.
• Women may experience increased presenteeism or cephalalgophobia, requiring more rescue medications.