Clinical characteristics, efficacy and safety of patients older than 65 years with the use of anti-CGRP drugs in the central region of Spain

Abstract text (incl. figure legends and references)

Objectives: Most clinical trials evaluating anti-CGRP antibodies have demonstrated their effectiveness and safety in chronic and high-frequency episodic migraine in patients under 65 years of age. The main objective of this study is to describe the clinical characteristics, effectiveness and safety of antiCGRP in patients older than 65 years.

Material and methods: Retrospective observational study nested in a prospectively collected multicenter cohort of patients older than 65 years with chronic migraine or high-frequency episodic migraine (CIC-3) treated with anti-CGRP (erenumab, galcanezumab or fremanezumab). Demographic and clinical variables are collected, response as a reduction in the number of days of headache (DCM) and/or migraine (DMM) monthly at 3, 6 and 12 months, and the presence of adverse effects.

Results: 43 patients, mean age 70(SD:3.6) years, 39/43(90.7%) women, 29/43(67%) chronic migraine, migraine evolution time of 45(SD:15.2) years. , years of chronicity 14(10.4), 9.5(SD:3.8) preventive treatments, 17/43(39.5%) psychiatric comorbidity and 24/43(55.8%) excessive use of medication. A reduction of 5 DCM at 3 months, 7 DCM at 6 months and 6 DCM at 12 months (p<0.05), and 11 DMM at 3 months, 13 DMM at 6 months and 11 DMM at 3 months was observed. 12 months (p<0.05); we found that 11/43 (25.6%) of the patients had some adverse effect.

Conclusions: According to our series, the use of antiCGRP drugs seems effective and safe in patients older than 65 years. Future studies with a larger number of patients and a longer follow-up period are necessary to corroborate these findings.