Table 3.
Certainty in the assessment of efficacy outcomes for anti-calcitonin gene-related peptide monoclonal antibodies for prevention in episodic migraine
| Certainty assessment | Certainty | |||||||
|---|---|---|---|---|---|---|---|---|
| Number of studies | Study design | Risk of bias | Inconsistency | Indirectness | Imprecision | Other considerations | ||
| Eptinezumab | ||||||||
| 1000 mg quarterly ev | 1 | RCT | not serious | seriousa | not serious | seriousb | none | ⨁⨁◯◯ LOW |
| Erenumab | ||||||||
| 70 monthly sc (except functional improvement) | 3 | RCT | not serious | not serious | not serious | not serious | none | ⨁⨁⨁⨁ HIGH |
| 70 monthly sc (functional improvement) | 1 | RCT | not serious | seriousa | not serious | not serious | none | ⨁⨁⨁◯ MEDIUM |
| 140 monthly sc | 1 | RCT | not serious | seriousa | not serious | not serious | none | ⨁⨁⨁◯ MEDIUM |
| Fremanezumab | ||||||||
| 225 monthly sc | 2 | RCT | not serious | not serious | not serious | not serious | none | ⨁⨁⨁⨁ HIGH |
| 675 quarterly sc | 1 | RCT | not serious | seriousa | not serious | not serious | none | ⨁⨁⨁◯ MEDIUM |
| Galcanezumab | ||||||||
| 240 mg ld + 120 mg monthly sc | 2 | RCT | not serious | not serious | not serious | not serious | none | ⨁⨁⨁⨁ HIGH |
| 240 mg monthly sc | 2 | RCT | not serious | not serious | not serious | not serious | none | ⨁⨁⨁⨁ HIGH |
sc: subcutaneous; ev: endovenous; RCT: randomized controlled trial. aInconsistency because of lack of replication; bImprecision because of exploratory study. The inconsistency for the Galcanezumab study was changed from serios to not serios, and the certainty from medium to high