García Castillo, María ClaraSierra Mencía, ÁlvaroCaronna, EdoardoToledo Alfocea, DanielJaimes, AlexUrtiaga, SarayCasas Limón, JavierMuñoz Vendrell, AlbertSantos Lasaosa, SoniaGarcía Martín, ValvanuzMartín Ávila, GuillermoPolanco, MarcosVillar Martínez, María DoloresTrevino Peinado, CristinaRubio Flores, LauraSánchez Soblechero, AntonioPortocarrero Sánchez, LeonardoLuque Buzo, ElisaLozano Ros, AlbertoGago Veiga, Ana BeatrizDíaz de Terán, JavierRecio García, AndreaCanales Rodríguez, JavieraGómez García, AndreaGonzález Salaices, MartaCampoy Diaz, SergioMínguez Olaondo, AneManiataki, StefaniaGonzález Quintanilla, VicentePorta Etessam, JesúsCuadrado, María LuzGuerrero Peral, Ángel LuisPozo Rosich, PatriciaRodríguez Vico, JaimeHuerta Villanueva, MarianoPascual, JulioGoadsby, Peter J.González Martínez, Alicia2025-07-162025-07-162025-06-031432-1459https://hdl.handle.net/2445/222276Background Preclinical evidence supports the immunoregulatory role of calcitonin gene-related peptide (CGRP) in migraine pathophysiology. The increasing use of anti-CGRP therapies in patients with migraine and other comorbidities raises the question whether the potential use of anti-CGRP monoclonal antibodies (CGRP-mAbs) therapies in combination with other immunological therapies is effective and safe. Methods This multicenter study included patients with migraine receiving CGRP-mAbs combined with immunosuppressive and immunomodulatory treatments. Clinical and demographic data, treatment history, laboratory markers and treatment-emergent adverse events (TEAEs) were analyzed. Effectiveness outcomes included the change in monthly migraine days (MMD) and monthly headache days (MHD) at 3, 6, 9 and 12 months, alongside the > 50% response rate. Moreover, autoimmune disease progression was also evaluated. We explored differences between patients with and without autoimmune disease activation. Results Among 89 patients, there were 80 (90%) females with a mean age of 50 years (SD: 11), who had a high prevalence of psychiatric comorbidities (anxiety 44%, depression 49%) and medication overuse (68%). Patients receiving immunological treatments experienced significant reductions in MMD and MHD, with MMD decreasing from 16 (SD: 7) at baseline to 9 (SD: 8) at 6 months, and MHD dropping from 23 (SD: 8) to 17 (SD: 11). A 50% response in MMD was achieved by 46% at 6 months. TEAEs were reported in 28%, most commonly constipation (16%) and dizziness (9%). Conclusions CGRP-mAbs therapies combined with immunological treatments appear effective and safe in patients with autoimmune diseases. Larger prospective studies are necessary to confirm these findings and optimize management strategies.12 p.application/pdfengcc-by (c) García Castillo, María Clara et al., 2025http://creativecommons.org/licenses/by/3.0/es/MigranyaImmunofarmacologiaMigraineImmunopharmacologyinfo:eu-repo/semantics/article2025-07-14info:eu-repo/semantics/openAccess40461909