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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Muñoz-Vendrell Albert, Campoy Sergio, Caronna Edoardo, Alpuente Alicia, Torres-Ferrus Marta, Nieves Castellanos Candela, Olivier Marina, Campdelacreu 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, Gonzalez-Martinez 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
Аннотация
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 10.1 ± 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%).
CONCLUSIONS: Anti-CGRP mAbs are safe and effective treatments in migraine patients over 65 years old in real-life clinical practice.