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Table 1 Possible predictors of (in) efficacy

From: Ten open questions in migraine prophylaxis with monoclonal antibodies blocking the calcitonin-gene related peptide pathway: a narrative review

Clinical features

Anti-CGRP/rec monoclonal antibody

POSITIVE PREDICTORS (post-hoc analysis)

 Unilateral headache [52, 53]

erenumab

galcanezumab

 Presence of cranial autonomic symptoms [54]

erenumab, fremanezumab, galcanezumab

 Less severe disability [34, 55]

erenumab

 Higher baseline migraine frequency [28, 52, 55]

erenumab

 Good response to triptans [23, 53, 56]

erenumab

galcanezumab

 Vomiting, all typical migraine features, good response to triptans more frequent in super-responders (\(\ge\) 75%) [23]

erenumab, fremanezumab, galcanezumab

 Absence of other headache types [28, 56]

erenumab

 Younger age [36]

fremanezumab

 Higher susceptibility to CGRP-triggered attacks [58]

erenumab

 Higher pre-treatment salivary CGRP [59]

erenumab

Treatment-induced changes associated with good outcome

 50% reduction of MIDAS or monthly migraine days at 3 months [57]

erenumab

 Increased thresholds of biceps femoris withdrawal reflex at 3 months [60]

erenumab

 Lower serum CGRP after 4 weeks (but not pre-treatment) [61]

erenumab

 Less iron accumulation in PAG and anterior cingulate cortex at 8 weeks post-injection [62]

erenumab

NEGATIVE PREDICTORS (post-hoc analysis)

 Chronic migraine [15, 23]

erenumab,

fremanezumab, galcanezumab

 Chronic migraine with continuous pain [15, 17, 28, 29, 49]

erenumab

 Medication-overuse headache [23, 34]

erenumab,

fremanezumab, galcanezumab

 Comorbid depression [23]

erenumab, fremanezumab, galcanezumab

 Multiple previous preventive failures [15, 28, 33, 34]

erenumab

 Higher baseline migraine frequency [28, 35]

erenumab

 Interictal cephalic allodynia [51]

galcanezumab