Background and importance Migraine is a neurological disorder characterised by episodic and recurrent seizures. Erenumab and galcanezumab are two monoclonal antibodies (MA) indicated for the prophylaxis of migraine in adults. They are recently marketed drugs, so it was necessary to determine their effectiveness.
Aim and objectives This study analysed the effectiveness of these MA in a series of patients in a third-level hospital.
Material and methods Retrospective observational study. Study period: January 2020–April 2021.
To start treatment, patients must be diagnosed with chronic or episodic migraine, having at least 8 migraine days per month and after having failed three or more previous treatments, one of them being botulinum toxin in the case of chronic migraine. This treatment is dispensed in the outpatient consultation service of the Hospital Pharmacy after a clinical interview in which all variables are recorded. To evaluate the effectiveness, we analysed the number of days with migraine attacks per month and the consumption of concomitant-related medication.
Results 53 patients (49 women, 4 men). Median age: 50 (range 21–77) years.
Diagnosis: chronic migraine: 41 patients; episodic migraine: 12 patients.
Treatment: erenumab 140 mg: 46 patients; erenumab 70 mg: 5 patients; galcanezumab 120 mg: 2 patients.
Received doses: galcanezumab: 6 doses: 2 patients; erenumab: 12 or more doses: 10 patients; 6–11 doses: 27 patients; 3–5 doses: 11 patients; fewer than 3 doses: 3 patients.
The median number of monthly episodes suffered pre-treatment was 20 (9–30). After 3 months, the median was 9 (1–30): 45% of episodes. After 6 months: 7 (0–28): 35% of episodes. After 12 months: 13 (4–28): 65% of episodes. 4 patients suspended treatment due to lack of effect.
The rest of the antimigraine drugs consumed prior to the use of MA, at the beginning, after 3 months and after 6 months of treatment were:
Beta-blockers: 22.22%, 1.85%, 0%, 0%.
Calcium antagonists: 20.37%; 1.85%, 0%, 0%.
Antiepileptics: 38.89%; 1.85%,1.96%, 0%.
Nonsteroidal anti-inflammatory drugs (NSAIDs): 25.92%; 29.63%, 45.09%; 16.21%.
Triptans: 38.88%; 62.96%, 50.98%, 18.91%.
No interactions with MAs were identified.
Conclusion and relevance The use of subcutaneous MA reduced the median of seizures per month significantly at 3 and 6 months. Although a rebound is observed at 12 months, the result of this is difficult to assess due to the small number of patients (10). The consumption of other antimigraine drugs was also reduced.
Conflict of interest No conflict of interest