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4CPS-048 Improving safety in the use of monoclonal antibodies in patients with migraine: an interdisciplinary study
  1. MA Carvajal-Sanchez1,
  2. A Machado-Leon2,
  3. J Leon-Villar1,
  4. P Pacheco-Lopez1,
  5. J Ibañez-Caturla1,
  6. L Fructuoso-Gonzalez1,
  7. P Torrano-Belmonte1,
  8. M Hernandez-Sanchez1,
  9. JA Gutierrez-Sanchez1,
  10. J Plaza-Aniorte1
  1. 1Hospital Morales Meseguer, Hospital Pharmacy, Murcia, Spain
  2. 2Hospital Rafael Mendez, Endocrinology Service, Lorca, Spain


Background and importance Erenumab and galcanezumab are two subcutaneously administered monoclonal antibodies (MAs) indicated for migraine prophylaxis in adults.

These MAs are newly marketed drugs. The integration of the hospital pharmacist (HP) in interdisciplinary teams (IT) has been shown to reduce the complications of these treatments. In addition, it improves monitoring of health outcomes, reduces unnecessary medication, treatment costs and minimises hospital admissions.

Aim and objectives To analyse the outcomes after the creation of an MA dispensing circuit and an IT composed of neurologists, nutritionists and HPs. This team focused on the treatment of migraine and the early detection, treatment and prevention of adverse reactions (AR).

Material and methods Retrospective observational study conducted from January 2020 to September 2021. Patients diagnosed with chronic or episodic migraine under treatment with MA were included.

These treatments are exclusively prescribed by the neurologist and are dispensed in the outpatient consultation services by an HP. The HP conducted the clinical interview, recorded effectiveness data, AR and other clinical data of interest, and generated the corresponding report in the patient’s medical record. In addition, the HP provided pharmaceutical advice and all necessary information to the patient. The nutritionist prepared the nutritional recommendations for the treatment and prevention of constipation.

Results During the study period 77 patients (85.7% female) were attended, with a median age of 51 (22–79) years.

The occurrence of constipation was detected in 30 patients (38.96%), substantially higher than that described in the pivotal trials (PT) of reference: erenumab 70 mg: 1.3%; 140 mg: 3.2%. Galcanezumab 120 mg: 1%; 240 mg: 1.5% and in the erenumab therapeutic positioning report (TPR): 3.3%.

The occurrence of hypertension was also detected in 7 patients (9.09%), not described in the PT or TPR.

All AR were reported. Oral and written information was provided to the patient.

Conclusion and relevance The creation of the IT brings value in the quality of healthcare and fosters cooperation between physician, nutritionist and HP. Furthermore, it favours early detection, prevention and treatment of AR.

Conflict of interest No conflict of interest

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