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cc by (c) Muñoz Vendrell, Albert et al, 2023
Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/204325

Effectiveness and safety of anti-CGRP monoclonal antibodies in patients over 65 years: a real-life multicentre analysis of 162 patients

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Background Anti-CGRP monoclonal antibodies have shown notable effectiveness and tolerability in migraine patients; however, data on their use in elderly patients is still lacking, as clinical trials have implicit age restrictions and real-world evidence is scarce. In this study, we aimed to describe the safety and effectiveness of erenumab, galcanezumab and fremanezumab in migraine patients over 65 years old in real-life. Methods In this observational real-life study, a retrospective analysis of prospectively collected data from 18 different headache units in Spain was performed. Migraine patients who started treatment with any anti-CGRP monoclonal antibody after the age of 65 years were included. Primary endpoints were reduction in monthly migraine days after 6 months of treatment and the presence of adverse effects. Secondary endpoints were reductions in headache and medication intake frequencies by months 3 and 6, response rates, changes in patient-reported outcomes and reasons for discontinuation. As a subanalysis, reduction in monthly migraine days and proportion of adverse effects were also compared among the three monoclonal antibodies. Results A total of 162 patients were included, median age 68 years (range 65-87), 74.1% women. 42% had dyslipidaemia, 40.3% hypertension, 8% diabetes, and 6.2% previous cardiovascular ischaemic disease. The reduction in monthly migraine days at month 6 was 10.17.3 days. A total of 25.3% of patients presented adverse effects, all of them mild, with only two cases of blood pressure increase. Headache and medication intake frequencies were significantly reduced, and patient-reported outcomes were improved. The proportions of responders were 68%, 57%, 33% and 9% for reductions in monthly migraine days >= 30%,>= 50%,>= 75% and 100%, respectively. A total of 72.8% of patients continued with the treatment after 6 months. The reduction in migraine days was similar for the different anti-CGRP treatments, but fewer adverse effects were detected with fremanezumab (7.7%). Conclusions Anti-CGRP mAbs are safe and effective treatments in migraine patients over 65 years old in real-life clinical practice.

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MUÑOZ VENDRELL, Albert, CAMPOY DIAZ, Sergio, CARONNA, Edoardo, ALPUENTE, Alicia, TORRES FERRUS, Marta, NIEVES CASTELLANOS, Candela, OLIVIER, Marina, CAMPDELACREU I FUMADÓ, Jaume, PRAT, Joan, CAMIÑA MUÑIZ, Javier, MOLINA MARTÍNEZ, Francisco josé, MÍNGUEZ OLAONDO, Ane, RUIBAL SALGADO, Marta, SANTOS LASAOSA, Sonia, NAVARRO PÉREZ, María pilar, MOROLLÓN, Noemí, LÓPEZ BRAVO, Alba, CANO SÁNCHEZ, Luis miguel, GARCÍA SÁNCHEZ, Sonia maría, GARCÍA ULL, Jésica, RUBIO FLORES, Laura, GONZÁLEZ MARTÍNEZ, Alicia, QUINTAS, Sonia, ECHAVARRÍA ÍÑIGUEZ, Ana, GIL LUQUE, Sendoa, CASTRO SÁNCHEZ, María victoria, ADELL ORTEGA, Vanesa, GARCÍA ALHAMA, Jessica, BERROCAL IZQUIERDO, Nuria, BELVÍS, Robert, DÍAZ INSA, Samuel, POZO ROSICH, Patricia, HUERTA VILLANUEVA, Mariano. Effectiveness and safety of anti-CGRP monoclonal antibodies in patients over 65 years: a real-life multicentre analysis of 162 patients. _The Journal of Headache and Pain_. 2023. Vol. 24, núm. 1. [consulta: 25 de febrer de 2026]. ISSN: 1129-2377. [Disponible a: https://hdl.handle.net/2445/204325]

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