4CPS-209 Long-term outcomes and retreatment patterns in anti-CGRP therapy

<h3>Background and Importance</h3> Anti-CGRP antibodies are a recent treatment used for migraine prophylaxis in patients with frequent migraines, prescribed after failure of other therapies. There is ongoing debate regarding the optimal duration of therapy, with some guidelines recommending reassessment after 1 year . However, the lack of long-term data and potential risk of relapse raises uncertainty about the appropriateness of treatment discontinuation. <h3>Aim and Objectives</h3> To evaluate the number of retreatments required in migraine patients who discontinued anti-CGRP antibody therapy after 1 year of adequate response, with a detailed descriptive analysis of those who discontinued the therapy. To assess whether there are significant differences in retreatment rates between patients with six or fewer prior migraine prophylaxis treatments and those with seven or more. <h3>Material and Methods</h3> A retrospective observational study was conducted in a medium-sized hospital from January 2021 to October 2024. Follow-up and the number of prior treatment lines was assessed through outpatient dispensing records, patients‘ electronic medical records and electronic prescription system. The Chi-squared test was used to compare the total proportions of retreatments. <h3>Results</h3> Among 119 patients, with a median of six prior treatment lines (IQR 5–8), 70 had been receiving anti-CGRP therapy for more than 1 year. Of these, 36 patients (51.5%) discontinued the treatment after 1 year. Notably, 27 of the patients who discontinued (75%) required retreatment, highlighting the challenge of maintaining long-term control over symptoms. 14 patients remained on the same anti-CGRP therapy. Of the 13 patients who transitioned to a second anti-CGRP therapy, five subsequently switched to a third anti-CGRP agent, and one patient underwent four treatment switches. Regarding those needing retreatment, eight did so within the first 3 months, 13 between 3 months and 1 year, and six after a period of 1 year. There is no statistically significant difference in retreatment rates between patients with six or fewer prior prophylactic treatments and those with seven or more (p = 0,582). <h3>Conclusion and Relevance</h3> More than half of the patients stopped treatment within a year, with 75% needing retreatment. This underscores the challenges in sustaining symptom control and emphasises the need for personalised approaches, as treatment responses and retreatment timelines varied significantly across patients. <h3>References and/or Acknowledgements</h3> <h3>Conflict of Interest</h3> No conflict of interest