Muñoz-Vendrell, AlbertCampoy, SergioCaronna, EdoardoAlpuente Ruiz, AliciaTorres Ferrús, MartaNieves Castellanos, CandelaOlivier, M.Campdelacreu Fumadó, JaumePrat, JoanCamiña Muñiz, J.Molina Martínez, Francisco JoséMínguez Olaondo, AneRuibal, M.Santos Lasaosa, SoniaNavarro Pérez, María PilarMorollón, NoemíLópez Bravo, AlbaCano Sánchez, L.M.García-Sánchez, S.M.García-Ull, JesicaRubio-Flores, Laura.Gonzalez Martinez, AliciaQuintas, SoniaEchavarría Íñiguez, AnaGil Luque, SendoaCastro-Sánchez, M.V.Adell Ortega, V.García Alhama, J.Berrocal-Izquierdo, N.Belvís Nieto, RobertoDíaz Insa, SamuelPozo Rosich, PatriciaHuerta Villanueva, Mariano2025-06-182025-06-182023-06-02Muñoz-Vendrell, A., Campoy, S., Caronna, E., Alpuente, A., Torres-Ferrus, M., Nieves Castellanos, C., Olivier, M., Campdelacreu, J., Prat, J., Camiña Muñiz, J., Molina Martínez, F. J., Mínguez-Olaondo, A., Ruibal Salgado, M., Santos Lasaosa, S., Navarro Pérez, M. P., Morollón, N., López Bravo, A., Cano Sánchez, L. M., García-Sánchez, S. M., et al. (2023). Effectiveness and safety of anti-CGRP monoclonal antibodies in patients over 65 years: a real-life multicentre analysis of 162 patients. Journal of Headache and Pain, 24(1). https://doi.org/10.1186/S10194-023-01585-21129-236910.1186/S10194-023-01585-2https://hdl.handle.net/20.500.14454/3090Background: 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.]eng© The Author(s) 202365 years oldCalcitonin gene-related peptideMigraineMonoclonal antibodiesReal-worldjournal article2025-06-181129-2377