https://doi.org/10.4081/cc.2024.15768
Diaphragmatic small bowel disease in a patient with resistant migraine and medication overuse treated with galcanezumab
Submitted: 26 April 2024
Accepted: 13 December 2024
Published: 23 December 2024
Accepted: 13 December 2024
Abstract Views: 27
PDF: 22
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Background: Monoclonal antibodies directed against Calcitonin Gene-Related Peptide (CGRP) or its receptor have greatly improved the quality of life of migraine patients. However, these treatments must be administered with caution in patients with constipation or inflammatory bowel disease, considering that non-steroidal anti-inflammatory drugs, widely used by patients with migraine to treat attacks, may have gastrointestinal side effects.
Methods: After receiving informed consent, we obtained patient's information from her clinical documentation and archived medical records.
Results: We report the case of a patient with a clinical history of migraine with and without aura, paroxysmal hemicrania, and overuse of indomethacin, who received a diagnosis of symptomatic small bowel diaphragmatic disease under prophylactic treatment with galcanezumab. Due to the intestinal implications of CGRP, we decided to discontinue this therapy and begin OnabotulinumtoxinA treatment.
Conclusions: This case report recommends extreme caution when starting anti-CGRP mAbs treatment in patients with longstanding medication overuse with NSAIDs and abdominal symptoms.
Schoenen J, Manise M, Nonis R, Gérard P, Timmermans G. Monoclonal antibodies blocking CGRP transmission: An update on their added value in migraine prevention. Rev Neurol (Paris) 2020;176:788-803.
DOI: https://doi.org/10.1016/j.neurol.2020.04.027
Holzer P, Holzer-Petsche U. Constipation Caused by Anti-calcitonin Gene-Related Peptide Migraine Therapeutics Explained by Antagonism of Calcitonin Gene-Related Peptide's Motor-Stimulating and Prosecretory Function in the Intestine. Front Physiol 2022;12:820006.
Holzer P, Holzer-Petsche U. Constipation Caused by Anti-calcitonin Gene-Related Peptide Migraine Therapeutics Explained by Antagonism of Calcitonin Gene-Related Peptide's Motor-Stimulating and Prosecretory Function in the Intestine. Front Physiol 2022;12:820006.
DOI: https://doi.org/10.3389/fphys.2021.820006
Bangs ME, Kudrow D, Wang S, Oakes TM, Terwindt GM, Magis D, et al. Safety and tolerability of monthly galcanezumab injections in patients with migraine: integrated results from migraine clinical studies [published correction appears in BMC Neurol 2020;20:90]. BMC Neurol 2020;20:25.
DOI: https://doi.org/10.1186/s12883-020-01675-7
Slesser AA, Wharton R, Smith GV, Buchanan GN. Systematic review of small bowel diaphragm disease requiring surgery. Colorectal Dis 2012;14:804-13.
DOI: https://doi.org/10.1111/j.1463-1318.2011.02741.x
Dodick DW, Turkel CC, DeGryse RE, Aurora SK, Silberstein SD, Lipton RB, et al. PREEMPT Chronic Migraine Study Group. OnabotulinumtoxinA for treatment of chronic migraine: pooled results from the double-blind, randomized, placebo-controlled phases of the PREEMPT clinical program. Headache 2010;50:921-36.
DOI: https://doi.org/10.1111/j.1526-4610.2010.01678.x
Dodick DW. CGRP ligand and receptor monoclonal antibodies for migraine prevention: Evidence review and clinical implications [published correction appears in Cephalalgia 2019;39:1069]. Cephalalgia 2019;39:445-58.
DOI: https://doi.org/10.1177/0333102418821662
Tepper S, Ashina M, Reuter U, Brandes JL, Doležil D, Silberstein S, et al. Safety and efficacy of erenumab for preventive treatment of chronic migraine: a randomised, double-blind, placebo-controlled phase 2 trial. Lancet Neurol 2017;16:425-34.
DOI: https://doi.org/10.1016/S1474-4422(17)30083-2
Dodick DW, Ashina M, Brandes JL, Kudrow D, Lanteri-Minet M, Osipova V, et al. ARISE: A Phase 3 randomized trial of erenumab for episodic migraine. Cephalalgia 2018;38:1026-37.
DOI: https://doi.org/10.1177/0333102418759786
De Hoon J, Van Hecken A, Vandermeulen C, Yan L, Smith B, Chen JS, et al. Phase I, Randomized, Double-blind, Placebo-controlled, Single-dose, and Multiple-dose Studies of Erenumab in Healthy Subjects and Patients with Migraine. Clin Pharmacol Ther 2018;103:815-25.
DOI: https://doi.org/10.1002/cpt.799
De Hoon J, Van Hecken A, Vandermeulen C, Herbots M, Kubo Y, Lee E, et al. Phase 1, randomized, parallel-group, double-blind, placebo-controlled trial to evaluate the effects of erenumab (AMG 334) and concomitant sumatriptan on blood pressure in healthy volunteers. Cephalalgia 2019;39:100-10.
DOI: https://doi.org/10.1177/0333102418776017
Ferrari MD, Diener HC, Ning X, Galic M, Cohen JM, Yang R, et al. Fremanezumab versus placebo for migraine prevention in patients with documented failure to up to four migraine preventive medication classes (FOCUS): a randomised, double-blind, placebo-controlled, phase 3b trial [published correction appears in Lancet 2019]. Lance 2019;394:1030-40.
DOI: https://doi.org/10.1016/S0140-6736(19)31946-4
Ashina M, Saper J, Cady R, Schaeffler BA, Biondi DM, Hirman J, et al. Eptinezumab in episodic migraine: A randomized, double-blind, placebo-controlled study (PROMISE-1). Cephalalgia 2020;40:241-54.
DOI: https://doi.org/10.1177/0333102420905132
Alex A, Vaughn C, Rayhill M. Safety and Tolerability of 3 CGRP Monoclonal Antibodies in Practice: A Retrospective Cohort Study. Headache 2020;60:2454-62.
DOI: https://doi.org/10.1111/head.13956
Robblee J, Devick KL, Mendez N, Potter J, Slonaker J, Starling AJ. Real-World Patient Experience with Erenumab for the Preventive Treatment of Migraine. Headache 2020;60:2014-25.
DOI: https://doi.org/10.1111/head.13951
Vernieri F, Altamura C, Brunelli N, Costa CM, Aurilia C, Egeo G, et al. Galcanezumab for the prevention of high frequency episodic and chronic migraine in real life in Italy: a multicenter prospective cohort study (the GARLIT study). J Headache Pain 2021;22:35.
DOI: https://doi.org/10.1186/s10194-021-01247-1
Hijos-Mallada G, Sostres C, Gomollón F. NSAIDs, gastrointestinal toxicity and inflammatory bowel disease. Gastroenterol Hepatol 2022;45:215-222.
DOI: https://doi.org/10.1016/j.gastre.2021.06.002
Hamid S, Yakoob J, Jafri W, Islam S, Abid S, Islam M. Frequency of NSAID induced peptic ulcer disease. J Pak Med Assoc 2006;56:218–22.
Sostres C, Gargallo CJ, Lanas A. Nonsteroidal anti-inflammatory drugs and upper and lower gastrointestinal mucosal damage. Arthritis Res Ther 2013.
DOI: https://doi.org/10.1186/ar4175
Shin SJ, Noh CK, Lim SG, Lee KM, Lee KJ. Non-steroidal anti-inflammatory drug-induced enteropathy. Intest Res 2017;15:446–55.
DOI: https://doi.org/10.5217/ir.2017.15.4.446
Graham DY, Opekun AR, Willingham FF, Qureshi WA. Visible small-intestinal mucosal injury in chronic NSAID users. Clin Gastroenterol Hepatol 2005.
Watanabe T, Fujiwara Y, Chan FKL. Current knowledge on non-steroidal anti-inflammatory drug-induced small-bowel damage: a comprehensive review. J Gastroenterol 2019.
DOI: https://doi.org/10.1007/s00535-019-01657-8
Graham DY, Opekun AR, Willingham FF, Qureshi WA. Visible small-intestinal mucosal injury in chronic NSAID users. Clin Gastroenterol Hepatol 2005;3:55-9.
DOI: https://doi.org/10.1016/S1542-3565(04)00603-2
How to Cite
1.
Marcosano M, Brunelli N, Alesina A, Fofi L, Altamura C, Vernieri F. Diaphragmatic small bowel disease in a patient with resistant migraine and medication overuse treated with galcanezumab. Confinia Cephalal [Internet]. 2024 Dec. 23 [cited 2024 Dec. 27];34(2). Available from: https://www.confiniacephalalgica.com/site/article/view/15768
Copyright (c) 2024 the Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
Similar Articles
- Chiara Rosignoli, Agnese Onofri, Federico De Santis, Simona Sacco, Raffaele Ornello, Efficacy and safety of greater occipital nerve block with a small volume of lidocaine and methylprednisolone in tertiary headache center , Confinia Cephalalgica: Vol. 34 No. 2 (2024)
- Matilde Marini, Daniel Souza Monteiro de Araujo, Martina Chieca, Elisa Bellantoni, Gaetano de Siena, Alessandra Mastricci, Irene Scuffi, Martina Tesi, Pasquale Pensieri, Romina Nassini, Francesco De Logu, Lorenzo Landini, Aromatase inhibitors evoke periorbital allodynia in mice via calcitonin gene-related peptide and its receptors in Schwann cells , Confinia Cephalalgica: Vol. 34 No. 1 (2024)
- Ilaria Frattale, Laura Papetti, Fabiana Ursitti, Giorgia Sforza, Gabriele Monte, Luigi Mazzone, Massimiliano Valeriani, ID-Migraine test for pediatric population: preliminary results from the Italian validation , Confinia Cephalalgica: Vol. 34 No. 1 (2024)
- Francesco Casillo, Chiara Abagnale, Gabriele Sebastianelli, Antonio Di Renzo, Vincenzo Parisi, Ettore Cioffi, Mariano Serrao, Cherubino Di Lorenzo, Cortical excitability in patients with migraine with aura and depressive symptoms: a visual evoked potentials study , Confinia Cephalalgica: Vol. 34 No. 1 (2024)
- Michele Corrado, Elena Mazzotta, Gloria Vaghi, Francescantonio Cammarota, Federico Bighiani, Alessandro Antoniazzi, Daniele Martinelli, Maria Magdalena Pocora, Luca Martinis, Valentina Grillo, Sara Bottiroli, Armando Perrotta, Giuseppe Cosentino, Grazia Sances, Cristina Tassorelli, Roberto De Icco, Normative values of the nociceptive blink reflex habituation , Confinia Cephalalgica: Vol. 34 No. 1 (2024)
- Selene Attorre, Andrea Burgalassi, Giulia Vigani, Francesco De Cesaris, Marina Romozzi, Luigi Francesco Iannone, Sex and gender differences in the epidemiology, clinical features, and pathophysiology of trigeminal autonomic cephalalgias , Confinia Cephalalgica: Vol. 34 No. 2 (2024)
- Marta Allena, Michele Viana, Abstracts di interesse cefalalgico , Confinia Cephalalgica: Vol. 26 No. 1 (2016)
- Alfredo Costa, Giulia Perini, Camillo Imbimbo, Lucia Scanu, Matteo Cotta Ramusino, The diagnosis of Alzheimer’s disease: an update and current controversies , Confinia Cephalalgica: Vol. 32 No. 3 (2022)
- Mariano Martini, Francesco Brigo, Davide Orsini, The history of Encephalitis Lethargica: an Italian treatment for a still little-known disease. The experience of the Siena psychiatric hospital in the first half of the twentieth century. in a museum and archival research. , Confinia Cephalalgica: Vol. 33 No. 1 (2023)
- Gianni Core, Ermes Rosan, Massimo Radaelli, Myofascial treatment of muscle tension headaches and other non-pharmacological interventions , Confinia Cephalalgica: Vol. 26 No. 1 (2016)
You may also start an advanced similarity search for this article.
