6ER-029 Long-term experience with erenumab, galcanezumab and fremanezumab in the treatment of chronic migraine

<h3>Background and Importance</h3> Monoclonal antibodies targeting the calcitonin gene-related peptide (anti-CGRP): erenumab (ERE), galcanezumab (GAL), and fremanezumab (FRE), have shown clinical effectiveness in the treatment of chronic migraine (CM). However, long-term evidence remains limited. <h3>Aim and Objectives</h3> This study aimed to evaluate the 2 year effectiveness of anti-CGRP antibodies in patients with chronic migraine. <h3>Material and Methods</h3> A retrospective study (2020–2023) was conducted, including all patients diagnosed with CM who had initiated treatment at least two years prior. Demographic and clinical variables such as age, sex, type of anti-CGRP treatment, and the number of previous preventive treatments were analysed. Effectiveness was assessed by changes in Migraine Headache Days (MHD) and the number of days requiring specific symptomatic medication (ME). Data were recorded at baseline (week 0) and after 96 weeks of treatment. Responders were defined as those achieving a ≥50% reduction in MHD by week 96. A Wilcoxon signed-rank test was used to compare pre- and post-treatment data, with significance set at p ≤ 0.05. <h3>Results</h3> The study included 110 patients (mean age 47.4 years (27–66); 88.2% female). Treatment distribution was as follows: ERE (43.6%, n=48), FRE (18.2%, n=20), and GAL (38.2%, n=42). The mean number of failed preventive treatments was 7.3. At week 96, 54.5% (n=60) of patients were still receiving treatment: ERE (38.3%, n=23), FRE (21.7%, n=13), and GAL (38.3%, n=23). Significant reductions in MHD and ME from baseline were observed for ERE (MHD: 11.7 vs 21.8 days, p=0.002; ME: 5.6 vs 17.5 days, p=0.004), GAL (MHD: 8.9 vs 20.6 days, p&lt;0.001; ME: 6.8 vs 15.3 days, p=0.006), and FRE (MHD: 8 vs 16,1 days, p=0.023; ME: 4.1 vs 9.1 days, p=0.025). A ≥50% reduction in MHD was achieved by 52.9%, 75%, and 41.7% of patients on ERE, GAL, and FRE, respectively. <h3>Conclusion and Relevance</h3> Our findings demonstrate the long-term effectiveness of anti-CGRP antibodies in chronic migraine treatment. Further prospective studies with larger sample sizes are needed to confirm these results. <h3>References and/or Acknowledgements</h3> <h3>Conflict of Interest</h3> No conflict of interest