Background and importance Migraine is a disease with a high personal and socioeconomic impact. The new prophylactic treatments erenumab and galcanezumab showed benefits versus placebo with few side effects.
Aim and objectives To evaluate the effectiveness of erenumab and galcanezumab by changing the MIDAS score and reducing the number of migraine episodes 12 weeks after starting treatment.
Material and methods Retrospective descriptive study of patients who started treatment with erenumab or galcanezumab since their inclusion in the Hospital’s Pharmacotherapeutic Guide (10 March 2020), complying with the funding criteria and the use criteria established by the Pharmacy and Therapeutics Commission, and who have been in treatment for at least 12 weeks (end of study 23 April 2021). The main variable is combined and includes reduction of MIDAS scale by 30% when the baseline score was > 20 or ≥5 points when the baseline score was 11–20 and/or reduction in the number of monthly migraines of at least 50%, both variables at 12 weeks of treatment.
Results 74 patients, 82.4% women with a median age of 47 (IQR 14) years. 66.2% with chronic migraine, with a median number of monthly migraines of 15 (IQR 15) and a median MIDAS score of 76 (IQR 67). 48 (65%) patients started treatment with galcanezumab and 26 (35%) with erenumab. The main variable was reached in 62 patients (83.8%). Eight no-responder patients continued with the treatment. At week 24, 6 of them reached effectiveness.
At week 12, 7 patients (9.5%) stopped treatment, 6 due to lack of response, although 2 of them had reached one of the variables of the main variable, and 1 patient due to a suspected allergic reaction. According to the type of migraine (chronic or episodic) and the prescribed drug, there were not statistically significant differences in the main variable. Switch of treatment was done in 13 patients (17,5%) mainly due to lack of effectiveness.
Conclusion and relevance The effectiveness of the treatments at 12 weeks is high (83,8%). Two-thirds of the patients who did not reach the main variable continued with treatment and 75% of them achieved effectiveness at 24 weeks; so it seems that some patients may need a longer time in which to reach a response.
Conflict of interest No conflict of interest