TY - JOUR
T1 - Effectiveness and safety of anti-CGRP monoclonal antibodies in patients over 65 years :
T2 - a real-life multicentre analysis of 162 patients
AU - Muñoz-Vendrell, Albert
AU - Campoy Diaz, Sergio
AU - Caronna, Edoardo
AU - Alpuente, Alicia
AU - Torres-Ferrús, Marta
AU - Nieves Castellanos, Candela
AU - Olivier, Marina
AU - Campdelacreu, Jaume
AU - Prat, Joan
AU - Camiña Muñiz, Javier
AU - Molina Martínez, Francisco José
AU - Mínguez-Olaondo, Ane
AU - Ruibal Salgado, Marta
AU - Santos Lasaosa, Sonia
AU - Navarro Pérez, María Pilar
AU - Morollón Sánchez-Mateos, Noemí
AU - López Bravo, Alba
AU - Cano Sánchez, Luis Miguel
AU - García-Sánchez, Sonia María
AU - García-Ull, Jésica
AU - Rubio-Flores, Laura
AU - Gonzalez-Martinez, Alicia
AU - Quintas, Sonia
AU - Echavarría Íñiguez, Ana
AU - Gil Luque, Sendoa
AU - Castro-Sánchez, María Victoria
AU - Adell Ortega, Vanesa
AU - García Alhama, Jessica
AU - Berrocal-Izquierdo, Nuria
AU - Belvís, Roberto
AU - Díaz-Insa, Samuel
AU - Pozo-Rosich, Patricia
AU - Huerta Villanueva, Mariano
PY - 2023
Y1 - 2023
N2 - 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. 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. 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 10.1 ± 7.3 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%). Anti-CGRP mAbs are safe and effective treatments in migraine patients over 65 years old in real-life clinical practice. The online version contains supplementary material available at 10.1186/s10194-023-01585-2.
AB - 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. 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. 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 10.1 ± 7.3 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%). Anti-CGRP mAbs are safe and effective treatments in migraine patients over 65 years old in real-life clinical practice. The online version contains supplementary material available at 10.1186/s10194-023-01585-2.
KW - 65 years old
KW - Calcitonin gene-related peptide
KW - Migraine
KW - Monoclonal antibodies
KW - Real-world
U2 - 10.1186/s10194-023-01585-2
DO - 10.1186/s10194-023-01585-2
M3 - Article
C2 - 37268904
SN - 1129-2377
VL - 24
JO - Journal of Headache and Pain
JF - Journal of Headache and Pain
ER -
