Examinando por Autor "Alpuente Ruiz, Alicia"

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    Atogepant after anti-CGRP monoclonal antibodies failure in migraine: a multicenter real-world study of effectiveness, safety, persistence and predictors of response
    (BioMed Central Ltd, 2026-12-01) Muñoz-Vendrell, Albert ; Campoy-Díaz,Sergio; Valín-Villanueva, Paloma; Casas-Limón, Javier; Fernández-Lázaro, Iris; González-García, Nuria; Santos Lasaosa, Sonia; González Osorio, Yésica; Gonzalez-Martinez, Alicia; Campdelacreu Fumadó, Jaume ; Portocarrero-Sánchez, Leonardo; Cano Sánchez, Luis Miguel; García Sánchez, Sonia María; Pérez de la parte, Alba; Morollón, Noemí ; López Bravo, Alba; Mínguez Olaondo, Ane ; Sánchez Soblechero, A.; Lozano Ros, A.; Morales Hernández, Cristian; Andrés López, A.; Layos-Romero, A.; Caronna, Edoardo; Torres Ferrús, Marta; Alpuente Ruiz, Alicia; Pozo Rosich, Patricia; Belvís, Robert; García Azorín, David ; Diaz de Teran, Javier ; Guerrero Peral, Angel Luis ; Gago Veiga, Ana Beatriz ; Huerta Villanueva, Mariano
    Background: Atogepant is approved for migraine prevention and has shown strong efficacy in clinical trials. However, its effectiveness following failure of anti-CGRP monoclonal antibodies (MAbs) has not been evaluated in large real-world populations. Methods: This multicenter observational study conducted across Spanish headache units included adults with migraine who initiated atogepant after failure of ≥ 1 anti-CGRP MAb and had ≥ 3 months of follow-up. Baseline demographic and clinical variables were collected prospectively, with follow-up assessments at months 3 and 6. The primary outcome was the proportion of patients achieving a ≥ 50% reduction in monthly migraine days (MMD) at three months. Secondary outcomes included ≥ 30%, ≥ 75%, and 100% response rates; changes in headache days, pain intensity, acute medication use, and patient-reported outcomes; adverse events; treatment persistence; and factors associated with response. Results: A total of 252 patients were included (mean age 48.9 ± 12 years; 83.3% female; 80.6% with chronic migraine; 45.6% with continuous daily headache). Prior to atogepant, 39.7% had failed one anti-CGRP MAb, 27.0% two, 20.2% three, and 13.1% four. Median baseline MMD was 16, monthly headache days 27, and acute medication days 20. At 3 months, 44.4% achieved a ≥ 30% reduction in MMD, 29.7% ≥50%, and 11.7% ≥75%. Adverse events were reported in 52.5% of patients, most commonly constipation (30%) and nausea (25%). At three months, 26.2% had discontinued treatment (65.1% due to inefficacy, 28.8% due to intolerance). Treatment persistence at 180 days was 61% (95% CI 54 to 69%). A higher number of previously failed MAbs was independently associated with reduced odds of ≥ 50% response (RR 0.79, 95% CI 0.64 to 0.97). Moreover, a higher number of previously failed MAbs was associated with diminished improvements across multiple clinical endpoints, including headache frequency, intensity, acute medication use, and disability measures. Conclusion: Atogepant may represent a viable treatment option for patients with migraine who have failed anti-CGRP MAbs. In this large real-world cohort, approximately one-third of patients achieved a ≥ 50% response, despite a treatment-refractory profile. However, the likelihood of response decreases with a higher number of previously failed MAbs, and mild adverse events are frequent.
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    Ítem
    Effectiveness and safety of anti-CGRP monoclonal antibodies in patients over 65 years: a real-life multicentre analysis of 162 patients
    (BioMed Central Ltd, 2023-06-02) Muñoz-Vendrell, Albert; Campoy, Sergio; Caronna, Edoardo; Alpuente Ruiz, Alicia; Torres Ferrús, Marta; Nieves Castellanos, Candela ; Olivier, M.; Campdelacreu Fumadó, Jaume; Prat, Joan; Camiña Muñiz, J.; Molina Martínez, Francisco José ; Mínguez Olaondo, Ane; Ruibal, M.; Santos Lasaosa, Sonia; Navarro Pérez, María Pilar; Morollón, Noemí ; López Bravo, Alba ; Cano Sánchez, L.M.; García-Sánchez, S.M.; García-Ull, Jesica; Rubio-Flores, Laura; Gonzalez Martinez, Alicia; Quintas, Sonia ; Echavarría Íñiguez, Ana ; Gil Luque, Sendoa; Castro-Sánchez, M.V.; Adell Ortega, V.; García Alhama, J.; Berrocal-Izquierdo, N.; Belvís Nieto, Roberto; Díaz Insa, Samuel ; Pozo Rosich, Patricia ; Huerta Villanueva, Mariano
    Background: Anti-CGRP monoclonal antibodies have shown notable effectiveness and tolerability in migraine patients; however, data on their use in elderly patients is still lacking, as clinical trials have implicit age restrictions and real-world evidence is scarce. In this study, we aimed to describe the safety and effectiveness of erenumab, galcanezumab and fremanezumab in migraine patients over 65 years old in real-life. Methods: In this observational real-life study, a retrospective analysis of prospectively collected data from 18 different headache units in Spain was performed. Migraine patients who started treatment with any anti-CGRP monoclonal antibody after the age of 65 years were included. Primary endpoints were reduction in monthly migraine days after 6 months of treatment and the presence of adverse effects. Secondary endpoints were reductions in headache and medication intake frequencies by months 3 and 6, response rates, changes in patient-reported outcomes and reasons for discontinuation. As a subanalysis, reduction in monthly migraine days and proportion of adverse effects were also compared among the three monoclonal antibodies. Results: A total of 162 patients were included, median age 68 years (range 65–87), 74.1% women. 42% had dyslipidaemia, 40.3% hypertension, 8% diabetes, and 6.2% previous cardiovascular ischaemic disease. The reduction in monthly migraine days at month 6 was 10.1 ± 7.3 days. A total of 25.3% of patients presented adverse effects, all of them mild, with only two cases of blood pressure increase. Headache and medication intake frequencies were significantly reduced, and patient-reported outcomes were improved. The proportions of responders were 68%, 57%, 33% and 9% for reductions in monthly migraine days ≥ 30%, ≥ 50%, ≥ 75% and 100%, respectively. A total of 72.8% of patients continued with the treatment after 6 months. The reduction in migraine days was similar for the different anti-CGRP treatments, but fewer adverse effects were detected with fremanezumab (7.7%). Conclusions: Anti-CGRP mAbs are safe and effective treatments in migraine patients over 65 years old in real-life clinical practice. Graphical Abstract: [Figure not available: see fulltext.]