Background and Importance Monoclonal antibodies targeting the calcitonin gene-related peptide (anti-CGRP) are recently available for migraine treatment. Real-world data on the utilisation of these drugs in clinical practice is scarce, but this information could help hospital pharmacists afford a better selection of the available drugs. Aim and ObjectivesThe study aimed to explore differences in medication persistence in patients with migraine treated with erenenumab, a human monoclonal antibody that binds to the receptor for CGRP, or fremanezumab and galcanezumab, humanised monoclonal antibodies that bind CGRP. Material and Methods RPT is a drug registry of patients with migraine initiating biologic treatment in public university hospitals in Catalonia. For this study, we retrieved from the registry data of patients initiating treatment after 01/02/2020 with erenumab, fremanezumab or galcanezumab. The primary outcomes assessed were: gender, age, discontinuation rate, time to discontinuation, and the causes of it. We also collected data to measure the treatment response, such as migraine days per month and the validated quality of life scales (Migraine Disability Assessment Scale and Headache Impact Test-6).Retrieved data was dissociated before any analysis. Chisquare was used to compare proportions and t-Student for continuous variables. Results Data from 131 patients was retrieved: 55/131 were treated with erenumab and 76/131 with galcanezumab/fremanezumab. 85% of patients were women, with a median age of 51. Medication persistence three months after initiating treatment was 36/55 with erenumab and 57/76 with fremanezumab/galcanezumab. There were no significant differences between the two mechanisms of action.The mean time to discontinuation in patients treated with erenumab was 8,9 months and in patients treated with fremanezumab or galcanezumab, 6,8 months, without significant differences.2/19 and 3/19 patients discontinued treatment due to toxicity with erenumab and fremanezumab/galcanezumab, respectively.30/131 patients' treatment were switched to a different mechanism of action. A three-month follow-up after the treatment change revealed significant improvement in 15/30 patients. Conclusion and RelevanceMedication persistence in migraine treatment with anti-CGRP monoclonal antibodies seems similar for both mechanisms of action.More extensive studies are needed to clarify the difference in response to different anti-CGRP monoclonal antibodies.
considered to be at risk to each healthcare professional, offering them other treatment options based on efficacy, safety and cost. ResultsWe reviewed 36 patients under treatment with tofacitinib, 28 females (73%), average age 51.6 years. 32 patients had rheumatoid arthritis and 4 patients had ulcerative colitis. We identified 13 (36%) patients with an increased risk of major adverse cardiovascular events and malignances, and all of them had rheumatoid arthritis: 7 patients were aged 65+ years, 5 patients had cardiovascular risk factors, and 2 patients had a malignancy process. We sent 11 personalised reports to healthcare professionals. Conclusion and relevance One in three patients being treated with tofacitinib were affected by the security alert, and were considered to be a population at increased risk of major adverse cardiovascular events and malignances. This study allowed us to find these patients and communicate this information to healthcare professionals, providing them with an alternative treatment option based on efficacy, safety and cost.References and/or acknowledgements https://www.aemps. gob.
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