Low dose Galcanezumab for treating trigeminal autonomic cephalalgias: clinical observation from Colombia and Mexico on behalf of ASOLAC
Views: 110DOI:
https://doi.org/10.48208/HeadacheMed.2025.9Keywords:
Cluster headache, Hemicrania continua, SUNCT, SUNA, CGRP, Anti-Calcitonin Gene-Related Peptide ReceptorAbstract
Background
Although evidence exists regarding the efficacy of galcanezumab in treating cluster headaches and other trigeminal autonomic cephalalgias (TACs), data on its effectiveness at lower doses are still lacking.
Objective
To report the clinical outcomes of Latin American patients treated with galcanezumab (GNZ) at a dose approved for migraine.
Methods
This case series included patients with cluster headaches, hemicrania continua, and short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT-SUNA) who were treated with a 240 mg loading dose of GNZ followed by 120 mg monthly.
Results
A total of 18 subjects were included: 12 with cluster headaches, 4 with hemicrania continua, and 2 with SUNCT-SUNA who received 1 to 24 monthly cycles of GNZ. Among those with episodic cluster headaches, 7 of 8 patients experienced a reduction in attack frequency of more than 50%. In the chronic cluster headache group, this reduction was achieved in 2 of 4 patients. Additionally, 2 of the 4 patients with hemicrania continua became headache-free. In the SUNCT-SUNA group, 2 were included, both reduced their daily attack frequency from 120 to 30 and from 10 to 2, respectively.
Conclusions
These clinical observations suggest that lower doses of GNZ may be a viable option for treating Latin American patients with TACs.
Downloads
References
Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. Cephalalgia 2018;38:1–211. Doi:10.1177/0333102417738202. DOI: https://doi.org/10.1177/0333102417738202
San-Juan D, Velez-Jimenez K, Hoffmann J, Martínez-Mayorga AP, Melo-Carrillo A, Rodríguez-Leyva I, et al. Cluster headache: an update on clinical features, epidemiology, pathophysiology, diagnosis, and treatment. Frontiers in Pain Research 2024;5. Doi:10.3389/fpain.2024.1373528. DOI: https://doi.org/10.3389/fpain.2024.1373528
Diener HC, Tassorelli C, Dodick DW. Management of Trigeminal Autonomic Cephalalgias Including Chronic Cluster. JAMA Neurol 2023;80:308. Doi:10.1001/jamaneurol.2022.4804. DOI: https://doi.org/10.1001/jamaneurol.2022.4804
Goadsby PJ, Dodick DW, Leone M, Bardos JN, Oakes TM, Millen BA, et al. Trial of Galcanezumab in Prevention of Episodic Cluster Headache. New England Journal of Medicine 2019;381:132–41. Doi:10.1056/NEJMoa1813440. DOI: https://doi.org/10.1056/NEJMoa1813440
González-Quintanilla V, Pérez-Pereda S, Fontanillas N, Pascual J. First case of hemicrania continua responsive to galcanezumab. Neurological Sciences 2021;42:4775–6. Doi:10.1007/s10072-021-05476-9. DOI: https://doi.org/10.1007/s10072-021-05476-9
Moond V, Hamilton K, Martinez R, Carrizo C, Burish M. Refractory Short-Lasting Unilateral Neuralgiform Headache Attacks With Conjunctival Injection and Tearing (SUNCT) Responding to Erenumab Adjuvant Therapy: A Case Report. Cureus 2022. Doi:10.7759/cureus.24403. DOI: https://doi.org/10.7759/cureus.24403
Hong Y, Kang M-K, Moon H-S, Kim B-K, Cho S-J. Preventive therapy with galcanezumab for two consecutive cluster bouts in patients with episodic cluster headache: an observational multicenter study. J Headache Pain 2023;24:136. Doi:10.1186/s10194-023-01661-7. DOI: https://doi.org/10.1186/s10194-023-01661-7
Membrilla JA, Torres‐Ferrus M, Alpuente A, Caronna E, Pozo‐Rosich P. Efficacy and safety of galcanezumab as a treatment of refractory episodic and chronic cluster headache: Case series and narrative review. Headache: The Journal of Head and Face Pain 2022;62:1395–405. Doi:10.1111/head.14404. DOI: https://doi.org/10.1111/head.14404
Muñoz-Cerón JF, Rueda-Sánchez M, Pradilla-Vesga OE, Volcy M, Hernández N, Ramírez SF, et al. Guideline on the preventive treatment of chronic migraine, chronic tension type headache, hemicrania continua and new daily persistent headache on behalf of the Colombian Association of Neurology. Acta Neurológica Colombiana 2020;36:150–67. Doi:10.22379/24224022300. DOI: https://doi.org/10.22379/24224022300
Burroughs VJ, Maxey RW, Levy RA. Racial and ethnic differences in response to medicines: towards individualized pharmaceutical treatment. J Natl Med Assoc 2002;94:1–26.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Joe Muñoz-Cerón, Ildefonso Rodríguez, Carolina Guerra, Karina Vélez, Natalia Hernández, Paula Nieto-Rodríguez, Daniela Gomez Barrera (Author)
This work is licensed under a Creative Commons Attribution 4.0 International License.
