Visual hypersensitivity in patients treated with anti-calcitonin gene–related peptide (receptor) monoclonal antibodies

Simone de Vries Lentsch, Matthijs J.L. Perenboom, Johannes A. Carpay, Antoinette Maassen van den Brink, Gisela M. Terwindt*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Objective: To evaluate the effect of treatment with anti-calcitonin gene–related peptide (CGRP; receptor) antibodies on visual hypersensitivity in patients with migraine. Background: Increased visual sensitivity can be present both during and outside migraine attacks. CGRP has been demonstrated to play a key role in light-aversive behavior. Methods: In this prospective follow-up study, patients treated for migraine with erenumab (n = 105) or fremanezumab (n = 100) in the Leiden Headache Center were invited to complete a questionnaire on visual sensitivity (the Leiden Visual Sensitivity Scale [L-VISS]), pertaining to both their ictal and interictal state, before starting treatment (T0) and 3 months after treatment initiation (T1). Using a daily e-diary, treatment effectiveness was assessed in weeks 9–12 compared to a 4-week pre-treatment baseline period. L-VISS scores were compared between T0 and T1. Subsequently, the association between the reduction in L-VISS scores and the reduction in monthly migraine days (MMD) was investigated. Results: At 3 months, the visual hypersensitivity decreased, with a decrease in mean ± standard deviation (SD) ictal L-VISS (from 20.1 ± 7.7 to 19.2 ± 8.1, p = 0.042) and a decrease in mean ± SD interictal L-VISS (from 11.8 ± 6.6 to 11.1 ± 7.0, p = 0.050). We found a positive association between the reduction in MMD and the decrease in interictal L-VISS (β = 0.2, p = 0.010) and the reduction in ictal L-VISS (β = 0.3, p = 0.001). Conclusion: A decrease in visual hypersensitivity in patients with migraine after treatment with anti-CGRP (receptor) antibodies is positively associated with clinical response on migraine.

Original languageEnglish
Pages (from-to)926-933
Number of pages8
JournalHeadache
Volume63
Issue number7
Early online date26 Jun 2023
DOIs
Publication statusPublished - Jul 2023

Bibliographical note

Funding Information: Gisela Terwindt reports consultancy support from Novartis, Allergan, Lilly, Teva, and Lundbeck, and independent support from Dutch Research Council, the Dutch Heart & Brain Foundations, IRRF, and Dioraphte. Antoinette Maassen Van Den Brink reports consultancy or industry support from Novartis, Lilly, and Teva, and independent support from the Dutch Research Council and the Dutch Heart & Brain Foundations. Johannes Carpay reports consultancy support from Novartis, Allergan, Lilly, Lundbeck, and Teva.

Publisher Copyright: © 2023 The Authors. Headache: The Journal of Head and Face Pain published by Wiley Periodicals LLC on behalf of American Headache Society.

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