Why you don’t need to worry about Coronavirus COVID 19 just because you’re taking Aimovig, Ajovy, Emgality or Vyepti.
Coronavirus COVID-19 Aimovig Ajovy Emgality Vyepti – Myth BUSTED!
In this episode of The Headache Channel, Dr. Krob crushes a dangerous internet rumor that says people taking Aimovig, Ajovy, Emgality or Vyepti for migraine or cluster headache prevention have an increased risk of catching Coronavirus COVID-19 because these CGRP monoclonal antibody drugs weaken the immune system.
8 Reasons Why This Myth is Busted:
1) Your immune system doesn’t even need antibodies to fight a new virus in the first place. The innate immune system scans your body for virus proteins and kills infected cells — without antibodies. Virus proteins are “hung” outside infected cells on hooks called major histocompatibility complex (MHC). T cells patrol the body for these foreign proteins and release cytotoxic factors that kill infected cells, preventing the virus from spreading.
2) A dose of any one of these medicines (Aimovig / erenumab, Ajovy / fremanezumab, Emgality / galcanezumab, or Vyepti / eptinezumab) is a drop in the bucket. If you are a typical 165-pound person, you have 37,125 mg of your own antibodies circulating in your blood right now. The highest routine dose of any CGRP-blocking antibody medicine is 300 mg of Emgality / galcanezumab every month for cluster headache. That’s less than 1 percent of the total antibodies floating around in your system.
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The dose of antibodies that can change your immune function is huge compared to the dose of a CGRP-blocking antibody used for headaches like migraine headache or cluster headaches. We know this because we use antibodies, IVIG, for turning down overactive immune systems in conditions like myasthenia gravis, multiple sclerosis and Guillain Barre syndrome. If you weigh 165 pounds, the usual dose of IVIG antibodies required to treat you for one of those conditions would be 150,000 mg per dose. That’s 500 times the dose of any CGRP-blocking antibody medicine (Aimovig / erenumab, Ajovy / fremanezumab, Emgality / galcanezumab, or Vyepti / eptinezumab).
3) Doses of CGRP-blocking antibody medicine (Aimovig / erenumab, Ajovy / fremanezumab, Emgality / galcanezumab, or Vyepti / eptinezumab) are designed to lower unhealthy levels of CGRP function seen in migraines and cluster headaches and leave enough CGRP function for normal physiologic function (like digestive movements and blood pressure regulation)*. (*In most cases. In some people, Aimovig in particular appears to interfere with physiologic function and cause constipation and high blood pressure.)
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Some scientists and doctos suspect that CGRP-blocking antibodies could actually be useful to stop the uncontrolled immune response that makes some people with COVID-19 so sick.
4) These CGRP-blocking monoclonal antibodies are specifically chosen, and in some cases even designed, to avoid interacting with the immune response.
5) CGRP-blocking antibodies for migraine and cluster headache prevention are DIFFERENT from the majority of therapeutic antibodies which WERE designed to alter immune function in conditions like organ transplant and cancer therapy. Because the vast majority of antibody medications were made to alter immune function, a lot of doctors, pharmacists, nurses and other caregivers mistakenly assume that Aimovig, Emgality, Ajovy and Vyepti fall into the same category. The CGRP-blocking monoclonal antibodies for migraine and cluster headache prevention are NOT designed to suppress the immune system.
6) Controlling your migraines probably improves immune function. People with uncontrolled migraine have chronically elevated cortisol levels which weakens the immune system. Controlling migraines probably results in making the immune system healthier.
7) People with well-controlled headaches can avoid going to the doctor, urgent care or emergency department for treatment of migraine or cluster headaches. There are a lot of good reasons to go to the urgent care or emergency department, but a preventable migraine or cluster attack isn’t one of them.
8) In studies of thousands of people taking the CGRP-blocking monoclonal antibodies for migraine / cluster headache prevention, scientists and doctors specifically searched for any evidence that they were causing more viral infections. People on these medicines do not get sick more often.
The Headache Channel is for information and entertainment purposes only. If you need medical advice, please see your physician.
