Effectiveness and safety of anti-CGRP monoclonal antibodies in patients over 65 years : a real-life multicentre analysis of 162 patients
Muñoz-Vendrell, Albert (Hospital Universitari de Bellvitge)
Campoy Diaz, Sergio (Hospital Universitari de Bellvitge)
Caronna, Edoardo (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Alpuente, Alicia (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Torres-Ferrús, Marta (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Nieves Castellanos, Candela (Hospital Universitari I Politécnic La Fe)
Olivier, Marina (Hospital Universitari I Politécnic La Fe)
Campdelacreu, Jaume (Hospital Universitari de Bellvitge)
Prat, Joan (Hospital Universitari de Bellvitge)
Camiña Muñiz, Javier (Clínica Rotger Quirónsalud)
Molina Martínez, Francisco José (Hospital Universitari Son Espases)
Mínguez-Olaondo, Ane (Biodonostia Osasun Ikerketako Institutura (País Basc))
Ruibal Salgado, Marta (Biodonostia Osasun Ikerketako Institutura (País Basc))
Santos Lasaosa, Sonia (Hospital Clínico Universitario "Lozano Blesa" de Zaragoza)
Navarro Pérez, María Pilar (Hospital Clínico Universitario "Lozano Blesa" de Zaragoza)
Morollón, Noemí (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
López Bravo, Alba (Hospital Reina Sofía)
Cano Sánchez, Luis Miguel (Hospital Sant Joan Despí)
García-Sánchez, Sonia María (Hospital Sant Joan Despí)
García-Ull, Jésica (Hospital Clínic Universitari (València))
Rubio-Flores, Laura (Hospital Universitario General de Villalba)
Gonzalez-Martinez, Alicia (Hospital Universitario de La Princesa E Instituto de Investigación Sanitaria Princesa)
Quintas, Sonia (Hospital Universitario de La Princesa E Instituto de Investigación Sanitaria Princesa)
Echavarría Íñiguez, Ana (Hospital Clínico Universitario de Valladolid)
Gil Luque, Sendoa (Hospital Universitario de Burgos)
Castro-Sánchez, María Victoria (Hospital Regional Universitario Carlos Haya (Málaga))
Adell Ortega, Vanesa (Consorci Sanitari de L'Alt Penedès-Garraf)
García Alhama, Jessica (Consorci Sanitari de L'Alt Penedès-Garraf)
Berrocal-Izquierdo, Nuria (Parc Sanitari Sant Joan de Déu)
Belvís, Roberto (Institut d'Investigació Biomèdica Sant Pau)
Díaz-Insa, Samuel (Hospital Universitari i Politècnic La Fe (València))
Pozo-Rosich, Patricia (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Huerta Villanueva, Mariano (Hospital Universitari de Bellvitge)
Universitat Autònoma de Barcelona

Data:	2023
Resum:	Anti-CGRP monoclonal antibodies have shown notable effectiveness and tolerability in migraine patients; however, data on their use in elderly patients is still lacking, as clinical trials have implicit age restrictions and real-world evidence is scarce. In this study, we aimed to describe the safety and effectiveness of erenumab, galcanezumab and fremanezumab in migraine patients over 65 years old in real-life. In this observational real-life study, a retrospective analysis of prospectively collected data from 18 different headache units in Spain was performed. Migraine patients who started treatment with any anti-CGRP monoclonal antibody after the age of 65 years were included. Primary endpoints were reduction in monthly migraine days after 6 months of treatment and the presence of adverse effects. Secondary endpoints were reductions in headache and medication intake frequencies by months 3 and 6, response rates, changes in patient-reported outcomes and reasons for discontinuation. As a subanalysis, reduction in monthly migraine days and proportion of adverse effects were also compared among the three monoclonal antibodies. A total of 162 patients were included, median age 68 years (range 65-87), 74. 1% women. 42% had dyslipidaemia, 40. 3% hypertension, 8% diabetes, and 6. 2% previous cardiovascular ischaemic disease. The reduction in monthly migraine days at month 6 was 10. 1 ± 7. 3 days. A total of 25. 3% of patients presented adverse effects, all of them mild, with only two cases of blood pressure increase. Headache and medication intake frequencies were significantly reduced, and patient-reported outcomes were improved. The proportions of responders were 68%, 57%, 33% and 9% for reductions in monthly migraine days ≥ 30%, ≥ 50%, ≥ 75% and 100%, respectively. A total of 72. 8% of patients continued with the treatment after 6 months. The reduction in migraine days was similar for the different anti-CGRP treatments, but fewer adverse effects were detected with fremanezumab (7. 7%). Anti-CGRP mAbs are safe and effective treatments in migraine patients over 65 years old in real-life clinical practice. The online version contains supplementary material available at 10. 1186/s10194-023-01585-2.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	65 years old ; Calcitonin gene-related peptide ; Migraine ; Monoclonal antibodies ; Real-world
Publicat a:	Journal of headache and pain, Vol. 24 (june 2023) , ISSN 1129-2377

DOI: 10.1186/s10194-023-01585-2
PMID: 37268904

9 p, 1.6 MB

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