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

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...

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Autores: 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
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2023
País:España
Institución:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/204325
Acceso en línea:https://hdl.handle.net/2445/204325
Access Level:acceso abierto
Palabra clave:Anticossos monoclonals
Migranya
Monoclonal antibodies
Migraine
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spelling Effectiveness and safety of anti-CGRP monoclonal antibodies in patients over 65 years: a real-life multicentre analysis of 162 patientsMuñoz Vendrell, AlbertCampoy Diaz, SergioCaronna, EdoardoAlpuente, AliciaTorres Ferrus, MartaNieves Castellanos, CandelaOlivier, MarinaCampdelacreu i Fumadó, JaumePrat, JoanCamiña Muñiz, JavierMolina Martínez, Francisco JoséMínguez Olaondo, AneRuibal Salgado, MartaSantos Lasaosa, SoniaNavarro Pérez, María PilarMorollón, NoemíLópez Bravo, AlbaCano Sánchez, Luis MiguelGarcía Sánchez, Sonia MaríaGarcía Ull, JésicaRubio Flores, LauraGonzález Martínez, AliciaQuintas, SoniaEchavarría Íñiguez, AnaGil Luque, SendoaCastro Sánchez, María VictoriaAdell Ortega, VanesaGarcía Alhama, JessicaBerrocal Izquierdo, NuriaBelvís, RobertDíaz Insa, SamuelPozo Rosich, PatriciaHuerta Villanueva, MarianoAnticossos monoclonalsMigranyaMonoclonal antibodiesMigraineBackground 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.Springer Science and Business Media LLC2023info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://hdl.handle.net/2445/204325Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))reponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaInglésReproducció del document publicat a: https://doi.org/10.1186/s10194-023-01585-2The Journal of Headache and Pain, 2023, vol. 24, num. 1https://doi.org/10.1186/s10194-023-01585-2cc by (c) Muñoz Vendrell, Albert et al, 2023http://creativecommons.org/licenses/by/3.0/es/info:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/2043252026-05-27T06:46:51Z
dc.title.none.fl_str_mv Effectiveness and safety of anti-CGRP monoclonal antibodies in patients over 65 years: a real-life multicentre analysis of 162 patients
title Effectiveness and safety of anti-CGRP monoclonal antibodies in patients over 65 years: a real-life multicentre analysis of 162 patients
spellingShingle Effectiveness and safety of anti-CGRP monoclonal antibodies in patients over 65 years: a real-life multicentre analysis of 162 patients
Muñoz Vendrell, Albert
Anticossos monoclonals
Migranya
Monoclonal antibodies
Migraine
title_short Effectiveness and safety of anti-CGRP monoclonal antibodies in patients over 65 years: a real-life multicentre analysis of 162 patients
title_full Effectiveness and safety of anti-CGRP monoclonal antibodies in patients over 65 years: a real-life multicentre analysis of 162 patients
title_fullStr Effectiveness and safety of anti-CGRP monoclonal antibodies in patients over 65 years: a real-life multicentre analysis of 162 patients
title_full_unstemmed Effectiveness and safety of anti-CGRP monoclonal antibodies in patients over 65 years: a real-life multicentre analysis of 162 patients
title_sort Effectiveness and safety of anti-CGRP monoclonal antibodies in patients over 65 years: a real-life multicentre analysis of 162 patients
dc.creator.none.fl_str_mv 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
author Muñoz Vendrell, Albert
author_facet 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
author_role author
author2 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
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Anticossos monoclonals
Migranya
Monoclonal antibodies
Migraine
topic Anticossos monoclonals
Migranya
Monoclonal antibodies
Migraine
description 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.
publishDate 2023
dc.date.none.fl_str_mv 2023
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/204325
url https://hdl.handle.net/2445/204325
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.1186/s10194-023-01585-2
The Journal of Headache and Pain, 2023, vol. 24, num. 1
https://doi.org/10.1186/s10194-023-01585-2
dc.rights.none.fl_str_mv cc by (c) Muñoz Vendrell, Albert et al, 2023
http://creativecommons.org/licenses/by/3.0/es/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc by (c) Muñoz Vendrell, Albert et al, 2023
http://creativecommons.org/licenses/by/3.0/es/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Springer Science and Business Media LLC
publisher.none.fl_str_mv Springer Science and Business Media LLC
dc.source.none.fl_str_mv Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))
reponame:Dipòsit Digital de la UB
instname:Universidad de Barcelona
instname_str Universidad de Barcelona
reponame_str Dipòsit Digital de la UB
collection Dipòsit Digital de la UB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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