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4CPS-043 Efficacy and safety of anti-calcitonin gene-related peptide monoclonal antibodies for migraine prophylaxis: one-year real-life experience
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  1. L Estrada,
  2. G Cardona Peitx,
  3. L Dorado Bouix,
  4. S Marin,
  5. E Terricabras Mas,
  6. A Bocos-Baelo,
  7. C García-Castiñeira,
  8. S Garcia-Xipell,
  9. C Rodríguez-González,
  10. C Quiñones
  1. Hospital Universitari Germans Trias I Pujol, Pharmacy Department, Badalona, Spain

Abstract

Background and Importance Clinical manifestations of migraine compromise patient’s quality of life (QoL). Randomised studies showed monoclonal antibodies against calcitonin gene-related peptide (AM-anti-CGRP) reduce frequency and intensity of migraine episodes but there is still lack of real-life effectiveness and safety data in some clinical scenarios.

Aim and Objectives Assess the one-year efficacy and safety of AM-anti-CGRP in those patients’ refractory to other prophylactic treatments through clinical pharmacist assessment.

Material and Methods Observational and retrospective study including patients with chronic migraine (CM) or episodic migraine (EM) who started treatment with AM-anti-CGRP between March 2020 and March 2022 completing one-year treatment.

Pharmacotherapeutic follow-up was performed together with the Neurology team. Sex, age, type of migraine and number of previous treatments were collected. Migraine days per month (MDM) and QoL scale (HIT-6) was assessed at baseline, 6- and 12-months follow-up. Treatment response was considered if there was an improvement of 50% MDM at 6 months or ≥30% of HIT-6 at one year. Drug adverse effects that conditioned treatment continuation were assessed.

Results 42 patients were included (CM=29; EM=13), 69% female, mean age 44.6±9.9 years. 51 treatments were recorded (22 erenumab, 23 galcanezumab, 6 fremanezumab). Patients received a mean of 6±1.6 (erenumab group), 5.4±1.4 (galcanezumab group) and 6.2±1.5 (fremanezumab group) prior treatments.

Mean±SD baseline MDM and median (range) HIT-6 values were: 17.6±8.0 and 67(52–74) (erenumab group), 20.7±7.7 and 68(53–78) (galcanezumab group) and 20.8± 8.7 and 70 (52–72) (fremanezumab group) days.

Mean±SD MDM values at 6- and 12-month follow-up were: 6.4±4.6 and 6.2±4.5 (erenumab), 10.7±8.2 and 10.3±7.7 (galcanezumab) and 6.7±0.6 and 7.5±2.1 (fremanezumab).

Median (range) HIT-6 values at 6- and 12-month follow-up were: 58.5(44–78) and 53(44–74) (erenumab), 62(46–78) and 65(54–76) (galcanezumab) and 62(46–78) and 65(54–76) (fremanezumab).

14 (63.6%), 15 (65.2%) and 3 (50%) of patients, responded to erenumab, galcanezumab and fremanezumab, respectively.

3 patients discontinued treatment due to adverse effects (n=2 erenumab-group, n=1 fremanezumab-group).

Conclusion and Relevance High responses rates ≥50% were observed in the three groups, higher in the galcanezumab group although conclusions limited due to small sample. Results show treatments were safe and well-tolerated, with only 5.88% treatment discontinuations due to adverse effects. Multidisciplinary follow-up including clinical pharmacist assessment could help optimising treatment response and safety.

Conflict of Interest No conflict of interest.

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