Examinando por Autor "Caronna, Edoardo"

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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 ; Díaz de Terán, 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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    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, Luis Miguel; 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.]
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    Evaluation of the effectiveness and safety of anti-CGRP monoclonal antibodies in patients with migraine and autoimmune diseases: IMMUNO-CGRP study
    (John Wiley and Sons Inc, 2026-06) García Castillo, María ; Sierra-Mencía, Álvaro; Caronna, Edoardo ; Toledo-Alfocea, Daniel ; Jaimes, Alex; Urtiaga, Sarai; Casas-Limón, Javier ; Muñoz-Vendrell, Albert ; Santos Lasaosa, Sonia; García Martín, Valvanuz ; Martín Ávila, Guillermo; Polanco, Marcos; Villar-Martínez, María Dolores; Trevino-Peinado, Cristina; Rubio-Flores, Laura; Sánchez Soblechero, A; Portocarrero Sánchez, Leonardo; Luque-Buzo, Elisa; Lozano Ros, Alberto; Gago Veiga, Ana Beatriz; Díaz de Terán, Javier; Recio García, Andrea; Canales Rodríguez, Javiera; Gómez García, Andrea; González Salaices, Marta ; Campoy, Sergio; Mínguez Olaondo, Ane; Maniataki, Stefania; González-Quintanilla, Vicente; Porta-Etessam, Jesús; Cuadrado, María Luz; Guerrero Peral, Ángel Luis; Pozo Rosich, Patricia; Rodríguez Vico, Jaime; Huerta Villanueva, Mariano; Pascual, Julio; Goadsby, Peter J.; González Martínez, Alicia
    Objective: This study aimed to evaluate demographic characteristics, treatment effectiveness, and safety outcomes in patients with migraine undergoing anti-calcitonin gene-related peptide (CGRP) treatments regarding the presence of autoimmune diseases. Background: CGRP has an important role in migraine pathophysiology through neuronal modulation in the trigeminovascular nociceptive system and activation of neuro-inflammatory cascades. We hypothesized that autoimmune diseases may influence treatment response and safety profiles in patients with migraine treated with anti-CGRP treatments. Methods: This was a retrospective multicenter, age- and sex-matched cohort study in headache units/headache clinics in Spain and United Kingdom between May 2024 and May 2025 including patients treated with CGRP monoclonal antibodies from prospectively collected cohorts. Patients were assessed for demographics, migraine-related characteristics, treatment effectiveness (monthly migraine days [MMD] and/or monthly headache days [MHD]), and safety outcomes. The main outcome was the effectiveness measured by ≥50% response rate in MMD between the two groups. Secondary outcomes included other effectiveness measurements regarding the number of MMD and MHD and treatment emerging adverse events. Results: A total of 388 patients with migraine under anti-CGRP treatments (194 with autoimmune diseases and 194 age- and sex-matched controls without autoimmune diseases) were included. The proportion of patients achieving a ≥50% response rate in MMD was higher in patients without autoimmune diseases at 6 (69% vs. 53%; p = 0.006) and 9 months (74% vs. 52%; p = 0.006). Treatment emerging adverse events were comparable between the two groups (35% vs. 38%; p = 0.575). Patients with autoimmune disease had a significantly lower likelihood of achieving a ≥50% response in MMD compared with those without autoimmune disease (adjusted odds ratio, 0.61; 95% confidence interval, 0.44–0.85; p = 0.006), independent of comorbid depression and medication overuse. Conclusions: Our study shows that anti-CGRP treatments are effective and safe for patients with migraine regardless the presence of autoimmune diseases, although an increased treatment response in patient without autoimmune disorders compared to patients with autoimmune disorders was observed. These findings highlight the need for early intervention, tailored strategies, and vigilant monitoring in patients with migraine and autoimmune disorders. Further research should explore immunomodulatory approaches to enhance outcomes. (Figure presented.).