Background and Importance Migraine is a highly disabling neurovascular disorder characterised by a severe headache and trigeminovascular system activation, involving the release of calcitonin-gene related peptide (CGRP). Galcanezumab is a humanised monoclonal antibody blocking the CGRP.

Analyze:

• The effectiveness of galcanezumab in the prophylaxis of chronic migraine

• Response to other anti-CGRP monoclonal antibodies after galcanezumab failure

Material and Methods Observational-retrospective study from January 2020 to September 2022. Patients in whom at least one year had passed since the start of galcanezumab treatment were included.

Variables analysed: demographics, baseline migraine days/month (MDM), three months later, objective response rate (ORR) >50%, duration, reason for suspension, and action. The headache impact test (HIT-6) was performed at baseline vs after three months of treatment. This score presents a range between 36 and 78 (<49= little or no impact, 50-55= certain impact, 56-59= important impact, >60= very severe impact).

Quantitative variables were expressed as median (interquartile range).

Results 56 patients were included.

- 9%(5) of the patients continue with active treatment, 100% maintain effectiveness, median MDM: 3(2-6).

- 91% (51) discontinued treatment:

Conclusion and Relevance A high percentage of patients presented a good response to galcanezumab, with an improvement in the HIT-6 score.

A large number of patients who received temporary prophylaxis with galcanezumab did not require another visit to the neurologist. Most of the patients who required reintroduction of galcanezumab reached an ORR>50%.

Less than half of the patients who restarted therapy with a different anti-CGRP after galcanezumab failure, achieved an ORR>50%.

All patients who continued with galcanezumab from the start, maintained effectiveness of the treatment

Conflict of Interest No conflict of interest