{
  "abstract": "Background and Importance Preventive migraine therapies aim to reduce attack frequency and severity and improve quality of life (QoL). Atogepant, an oral anti-CGRP, is accessible in Spain for preventive treatment in patients with high-frequency episodic migraine (HFEM) and chronic migraine (CM).Aim and Objectives To evaluate the effectiveness of atogepant after anti-CGRP monoclonal antibody treatment, using a validated QoL questionnaire, and to describe its safety in real-world practice.Material and Methods A prospective observational study was conducted between 08/24-09/25. Data were collected from electronic medical records: sex, age, previous therapy, migraine type, treatment duration, discontinuation and concomitant botulinum toxin use. QoL was assessed at baseline week 0 (W0) and week 12 (W12) using the Migraine-Specific Quality of Life Questionnaire version 2.1 (MSQ), comprising three domains: Role Function–Restrictive (RFR), Role Function–Preventive (RFP), and Emotional Function (EF). Scores range from 0 to 100, higher scores indicating better QoL. The primary endpoint was the percentage of responders in the RFR domain, defined as patients with ≥25% mean improvement from baseline to W12, considered clinically relevant in the ADVANCE trial. Secondary endpoints were mean changes in each MSQ domain and total score. Adverse events (AEs) were obtained from medical records.Results Thirty patients were included, 93.3% (n=28) women, median age 47 years (36–61). All had previously received fremanezumab; 80% (n=24) had CM and 20% (n=6) HFEM. Median treatment duration was 5 months (1–13). Twelve patients (40%) discontinued, four before W12. Three patients combined atogepant with botulinum toxin.Atogepant was effective in 30% (n=9), 20% (n=6) showed partial improvement, and 50% (n=15) had no or negative change.Detailed MSQ scores and domain changes are presented in table 1: Domain/Week RFR RFP EF Total W0 (mean ± SD) 28.2 (±18.2) 32.5 (±19.9) 19.9 (±18.3) 27.6 (±16.8) W12 (mean ± SD) 40.2 (±26.7) 44 (±29) 29.9 (±29.6) 38.9 (±26.4) Difference (W12–W0) 12 (±29.2) 11.5 (±29.7) 10.1 (±24.6) 11.3 (±26.9) AEs occurred in 76.7% (n=23): constipation (47.8%), hyporexia (43.5%), nausea (34.8%), and weight loss (13.6%).Conclusion and Relevance The effectiveness of atogepant following anti-CGRP monoclonal antibody treatment, measured by QoL improvement, was limited, with one-third of patients achieving clinically relevant benefit. All MSQ domains showed minimal changes. Gastrointestinal adverse events were frequent. Larger studies with longer follow-up are needed to confirm these findings.Conflict of Interest No conflict of interest",
  "authors": [
    {
      "affiliations": [
        "Hospital Universitario Puerto Real, Pharmacy, Puerto Real, Spain"
      ],
      "name": "G Cano Martínez"
    },
    {
      "affiliations": [
        "Hospital Universitario Puerto Real, Pharmacy, Puerto Real, Spain"
      ],
      "name": "MD Gil-Sierra"
    },
    {
      "affiliations": [
        "Hospital Universitario Puerto Real, Pharmacy, Puerto Real, Spain"
      ],
      "name": "M Mora-Cortes"
    },
    {
      "affiliations": [
        "Hospital Universitario Puerto Real, Pharmacy, Puerto Real, Spain"
      ],
      "name": "CM Dominguez-Santana"
    },
    {
      "affiliations": [
        "Hospital Universitario Puerto Real, Pharmacy, Puerto Real, Spain"
      ],
      "name": "M Dominguez-Cantero"
    }
  ],
  "title": "4CPS-252 Effectiveness of atogepant after anti-CGRP monoclonal antibody: patient-reported outcomes on quality of life",
  "uid": "12b45392-30a7-5387-8be0-f2c3ed27669d"
}