Efficacy of galcanezumab for interictal neck pain associated with migraine

Abstract

　Neck pain is a highly prevalent associated symptom of migraine, occurring in approximately 77% of patients. It is often linked to increased disability and higher interictal burden. This study aimed to evaluate the efficacy of galcanezumab, an anti-calcitonin gene-related peptide (CGRP) monoclonal antibody, specifically focusing on the impact on interictal neck pain and the correlation with interictal burden.
　A total of 58 migraine patients who met the ICHD-3 criteria and experienced interictal neck pain were included in this analysis. Patients received galcanezumab (initial dose 240 mg, followed by 120 mg monthly) . The primary endpoints were changes in monthly migraine days (MMD) , Headache Impact Test-6 (HIT-6) , and the Migraine Interictal Burden Scale-4 (MIBS-4) . Neck pain was assessed using a Numerical Rating Scale (NRS) for Change. Assessments were conducted at baseline and monthly for three months.
　Galcanezumab administration led to significant reductions in MMD, HIT-6, and MIBS-4 scores from the first month of treatment (p<0.05) . Interictal neck pain scores also significantly improved, decreasingfrom a baseline of 10 to 4.4 ± 2.9 at three months. While no significant correlation was found between MMD reduction and neck pain improvement, a significant positive correlation was observed between the improvement in MIBS-4 and neck pain starting from the second month of treatment (r＝0.449, p＝0.0005) .
　Galcanezumab is effective not only in reducing migraine frequency but also in alleviating interictal neck pain. The correlation with MIBS-4 suggests that CGRP inhibition may mitigate neck pain by modulating central sensitization within the trigeminocervical complex (TCC) . These findings indicate that galcanezumab is a valuable therapeutic option for improving the quality of life in migraine patients with persistent neck symptoms.