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Is achieving higher standards in real-world migraine care feasible with anti-CGRP monoclonal antibodies preventive therapies?: Insights from the EUREkA cohort.

Researchers

Edoardo Caronna, Rut Mas-de-Les-Valls, Gabriella Egeo, Manuel Millán Vázquez, Candela Nieves Castellanos, Javier A Membrilla, Gloria Vaghi, Joana Rodríguez-Montolio, Neus Fabregat Fabra, Francisco Sánchez Caballero, Alex Jaimes, Albert Muñoz-Vendrell, Renato Oliveira, Gabriel Gárate, Yesica González Osorio, Daniel Guisado-Alonso, Raffaele Ornello, Cem Thunstedt, Iris Fernández-Lázaro, Antonio Sánchez-Soblechero, Andreas Kattem Husøy, Beatriz Nunes Vicente, Hauke Basedau, Nuria Pilar Riesco Pérez, Belen Flores Pina, Catarina Fernandes, Alberto Andrés-López, Elisa Martins-Silva, Sławomir Budrewicz, Pablo Ros Arlanzón, André Caetano, Victor José Gallardo, Laura Gómez-Dabó, Marta Torres-Ferrús, Alicia Alpuente, Paola Torelli, Cinzia Aurilia, Silvana Zapata, Raquel Lamas Pérez, Maria José Ruiz Castrillo, Roberto De Icco, Grazia Sances, Sarah Broadhurst, Hui Ching Ong, Jed Winstanley, Sonsoles Aranceta, Izaro Kortazar Zubizarreta, Amalia Echeverria Urabayen, Andrea Gómez García, Sergio Campoy, Inês Marques, Elsa Parreira, Vicente González-Quintanilla, Ángel Luis Guerrero-Peral, Isabel Miró, Julia Peris-Subiza, Valeria Caponnetto, Andreas Straube, Alicia Gonzalez-Martinez, Sonia Quintas, Margarita Sánchez-Del-Río, Erling Tronvik, Begoña Venegas Pérez, Agustin Oterino Durán, Miguel Rodrigues, Ana Fries Ramos, Yago Vaamonde Esteban, Sabina Cevoli, Bruno Colombo, Michele Trimboli, Fabio Frediani, Florindo d'Onofrio, Marco Aguggia, Antonio Salerno, Antonio Carnevale, Maurizio Zucco, Maria Albanese, Cinzia Finocchi, Angelo Ranieri, Francesco Zoroddu, Massimo Autunno, Jordi Sanahuja, Gonçalo Cabral, Isabel Beltrán Blasco, Marta Waliszewska-Prosół, Liliana Pereira, Almudena Layos-Romero, Isabel Luzeiro, Laura Dorado, Maria Rocio Álvarez Escudero, Arne May, Alba López-Bravo, Isabel Pavão Martins, Christina Sundal, Pablo Irimia, Alberto Lozano Ros, Ana Beatriz Gago-Veiga, Fernando Velasco Juanes, Ruth Ruscheweyh, Simona Sacco, Elisa Cuadrado-Godia, David García-Azorín, Julio Pascual, Raquel Gil-Gouveia, Mariano Huerta-Villanueva, Jaime Rodriguez-Vico, Javier Viguera Romero, Victor Obach, Sonia Santos-Lasaosa, Mona Ghadiri-Sani, Cristina Tassorelli, Javier Díaz-de-Terán, Samuel Díaz Insa, Carmen González Oria, Piero Barbanti, Patricia Pozo-Rosich

Abstract

BackgroundThe International Headache Society has proposed new treatment goals for migraine prevention in real world, as a way to set higher standards of care. This study provides the first assessment of the proportion of individuals achieving them after 6 months of migraine-specific treatment with anti-CGRP monoclonal antibodies (MAbs).MethodsThis was a prospective, real-world, European multicenter study, including adults with migraine treated with anti-CGRP MAbs (EUREkA cohort). We assessed the proportions of individuals in each treatment goal category-migraine freedom (no monthly migraine days [MMD]); optimal control (< 4 MMD), modest control (4-6 MMD); insufficient control (>6 MMD)-after 6 months of treatment. We also assessed the proportion of individuals with ≥50% reduction in MMD in the insufficient control group.ResultsOf the 5818 individuals in the EUREkA cohort, 4963 had 6 months data. Of these, 82.3% (4086/4963) were females and the median age was 48.0 [40.0-55.0] years. At baseline, the median monthly headache days [MHD] and MMD were 20.0 [13.3-28.0] and 15.0 [10.0-20.0], respectively. All participants were classified as having insufficient headache control (>6 MMD) at baseline. At month 6, 6.9% (342/4963) had migraine freedom, 22.9% (1137/4963) optimal control, 24.6% (1223/4963) modest control and 45.6% (2261/4963) insufficient control. In the insufficient control group, 27.1% (613/2261) had ≥50% reduction in MMD.ConclusionsHigh standards of care, defined as optimal disease control or even migraine freedom, are achieved in real-world settings with anti-CGRP MAbs in approximately 30% of individuals with a high migraine burden. These findings highlight the need to expand global access to these treatments. Future studies should explore whether initiating migraine-specific preventive treatments earlier could further reduce residual migraine days in responders, enabling a larger proportion of patients to achieve optimal disease control.
Source: PubMed (PMID: 42318706)View Original on PubMed