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076 Inflammatory complications of CGRP monoclonal antibodies
  1. Jason C Ray1,2,3,
  2. Penelope Allen4,5,
  3. Ann Bacsi6,
  4. Julian Bosco3,7,
  5. Luke Chen2,3,
  6. Michael Eller3,8,
  7. Lyndell Lim4,5,
  8. Hock Kua9,
  9. Manjit Matharu10,
  10. Mastura Monif2,3,11,
  11. Richard Stark2,3 and
  12. Elspeth Hutton2,3
  1. 1Department of Neurology, Austin Health, Melbourne, VIC, Australia
  2. 2Alfred Health, Melbourne, VIC, Australia
  3. 3Monash University, Melbourne, VIC, Australia
  4. 4Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, VIC, Australia
  5. 5Department of Surgery, University of Melbourne, Parkville, VIC, Australia
  6. 6Integrated Specialist Medical Care, Macquarie University Hospital and North Shore Private Hospital, Sydney, NSW, Australia
  7. 7Allergy, Asthma and Clinical Immunology, Alfred Health, Melbourne, VIC, Australia
  8. 8Department of Neurology, Monash Medical Centre, Melbourne, VIC, Australia
  9. 9Department of Pathology, Monash Medical Centre, Melbourne, VIC, Australia
  10. 10University College London (UCL) Queen Square Institute of Neurology and The National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
  11. 11Department of Neurology, Royal Melbourne Hospital, Melbourne, VIC, Australia


Background CGRP monoclonal antibodies (mAb) are an effective new preventative treatment for episodic and chronic migraine, with a favourable adverse event profile. In addition to its role in mediating migraine attacks, CGRP is widely expressed throughout the body and in general has an anti-inflammatory/immunoregulatory role. Thus, inhibitory CGRP may potentiate a pro-inflammatory state.

Methods/Results We present a case series of eight patients with new or worsened inflammatory pathology in close temporal association with the start of CGRP mAb therapy.

Conclusions This case series provides novel insights on the potential molecular mechanisms and side-effect profile of CGRP inhibition and warrants vigilance in clinical practice.

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