medalphabetМедицинский алфавитMedical alphabet2078-56312949-2807ООО «Альфмед»10.33667/2078-5631-2025-32-25-29medalphabet-4776Research ArticleСтатьиПредикторы сохранения ремиссии после окончания терапии анти-CGRP моноклональными антителами при мигрениPredictors of remission maintenance after discontinuation of anti-CGRP monoclonal antibody therapy in migrainehttps://orcid.org/0000-0002-1248-0545ГармановаА. А.GarmanovaA. A.

Гарманова Анна Александровна, врач-невролог

Москва

Garmanova Anna A., neurologist

Moscow

garmanova_aa@bk.ruhttps://orcid.org/0009-0008-7814-7076КотеневВ. Д.KotenevV. D.

Котенев Владимир Дмитриевич, ординатор кафедры нервных болезней ИПО

Москва

Kotenev Vladimir D., resident physician at Dept of Nervous Diseases, Institute of Postgraduate Education No. 2

Moscow

https://orcid.org/0000-0002-4447-2152БердниковаА. В.BerdnikovaA. V.

Бердникова Анна Владимировна, к.м.н., ассистент кафедры нервных болезней ИПО

Москва

Berdnikova Anna V., PhD Med, assistant professor at Dept of Nervous Diseases, Institute for Professional Education

Moscow

https://orcid.org/0000-0001-9600-5540ЛатышеваН. В.LatyshevaN. V.

Латышева Нина Владимировна, д.м.н., доцент, профессор кафедры нервных болезней ИПО; врач-невролог

Москва

Latysheva Nina V., Dr Med Sci (habil.), professor at Dept of Nervous Diseases, Institute for Professional Education, neurologist

Moscow

ФГБУ «Поликлиника №1» УД Президента РФРоссияPolyclinic No. 1 Department of the President of the Russian FederationRussian FederationФГАОУ ВО «Первый Московский государственный медицинский университет им. И. М. Сеченова» Минздрава России (Сеченовский университет)РоссияI. M. Sechenov First Moscow State Medical University (Sechenov University)Russian FederationФГАОУ ВО «Первый Московский государственный медицинский университет им. И. М. Сеченова» Минздрава России (Сеченовский университет); Клиника головной боли и вегетативных расстройств им. акад. Александра ВейнаРоссияI. M. Sechenov First Moscow State Medical University (Sechenov University); Alexander Vein Headache ClinicRussian Federation202526122025032Неврология и психиатрия (4)2529Copyright © Гарманова А.А., Котенев В.Д., Бердникова А.В., Латышева Н.В., 20252025Гарманова А.А., Котенев В.Д., Бердникова А.В., Латышева Н.В.Garmanova A.A., Kotenev V.D., Berdnikova A.V., Latysheva N.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-alphabet.com/jour/article/view/4776

Моноклональные антитела против CGRP или его рецептора стали новым этапом в профилактическом лечении мигрени, отличаясь высокой эффективностью и хорошей переносимостью. Однако оптимальная продолжительность такой терапии и факторы, определяющие поддержание ремиссии после ее завершения, остаются не до конца изученными. Целью нашего исследования было выявить предикторы длительной ремиссии после прекращения терапии анти-CGRP моноклональными антителами (анти-CGRP мАТ) при мигрени. В исследование включены 96 пациентов с мигренью, которые получали три и более инъекций анти-CGRP мАТ с последующим завершением терапии при снижении частоты головной боли не менее чем на 30 %. Полученные результаты позволили выявить основные факторы, способствующие сохранению ремиссии после окончания лечения. Ключевыми предикторами стали: быстрое и стойкое наступление терапевтического эффекта, меньшее количество дней с головной болью на момент завершения курса, более низкий уровень депрессии, менее выраженная центральная сенситизация, а также незначительное влияние головной боли на повседневную активность. Исследование подчеркивает значимость комплексной оценки состояния пациентов перед окончанием терапии и открывает возможности для индивидуализированного подхода к ведению больных мигренью с целью поддержания стойкой ремиссии и повышения качества жизни.

Monoclonal antibodies targeting CGRP or its receptor have marked a new era in the preventive treatment of migraine, demonstrating high efficacy and good tolerability. However, the optimal duration of such therapy and the factors influencing the maintenance of remission after its discontinuation remain insufficiently studied. The aim of our study was to identify predictors of sustained remission following the cessation of anti-CGRP monoclonal antibody therapy in migraine. The study included 96 patients with migraine who received three or more injections of anti-CGRP mAb and experienced at least a 30 % reduction in headache frequency. The results allowed us to identify key factors associated with maintenance of remission after the end of treatment. The principal predictors were: rapid and sustained onset of therapeutic effect, a lower number of headache days at the end of therapy, a lower level of depression, less marked central sensitization, and minimal impact of headache on daily activities. This study emphasizes the importance of comprehensive patient assessment before discontinuing therapy and highlights opportunities for an individualized approach in the management of migraine, aimed at maintaining long-term remission and improving quality of life.

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The authors declare that there are no conflicts of interest present.