Abstract text (incl. figure legends and references)

INTRODUCTION: aim of the present study was to compare anti-CGRP versus anti-CGRP-receptor monoclonal antibodies on migraine prevention in patients with high frequency episodic and chronic migraine.

MATERIALS AND METHODS: this observational study was conducted at the Headache Centre – ASST Spedali Civili Brescia. All patients in monthly treatment with an anti-CGRP (either molecule or receptor) monoclonal antibody (mAb) with an available 6 months follow-up were included. Clinical and demographical characteristics were gathered at baseline (T0) for all patients. Data regarding efficacy outcome were collected following one (T1), three (T3) and six (T6) months of treatment.

RESULTS: one hundred and thirty-three consecutive patients were enrolled, of whom 49 patients in treatment with an anti-CGRP (galcanezumab 120 mg) and 84 with the anti-CGRP-receptor (erenumab 140 mg). Both treatments showed a significant clinical improvement at T3 and T6. At T3, a significantly higher percentage of super responders (47.6% vs 23.1%) and a significantly lower percentage of non responders (14.3% vs 29.8%) was found in patients in treatment with galcanezumab compared to erenumab (p=0.02). Similarly, at T6, a significantly higher percentage of super responders (44.1% vs 26.6%) and a significantly lower percentage of partial responders (5.9% vs 25.4%) was found in patients on galcanezumab compared to erenumab (p=0.05).

CONCLUSIONS: the present study on a real-world sample confirms the beneficial effect of both monoclonal antibodies. The comparison of these treatments displayed no difference in term of adverse events while arguing for a more favorable clinical outcome for anti-CGRP antibodies.