{
  "abstract": "Background and Importance Oral calcitonin gene-related peptide(CGRP) antagonists have recently been approved for chronic migraine(CM) and high-frequency episodic migraine(HFEM) prophylaxis.Aim and Objectives Describe their effectiveness and security in clinical practice and assess any differences between patients previously treated with anti-CGRP antibodies (G1) and naïve (G2).Material and Methods A single-centre retrospective observational study was carried out, including patients receiving atogepant or rimegepant during 08/2024-01/2025, with efficacy/safety evaluation after 12 weeks.Variables: age, sex, migraine classification, nonspecific prophylactic treatments, anti-CGRP antibody treatment history, medication (atogepant/rimegepant), response rate (complete [CR]: ≥50% reduction in monthly migraine episodes; partial [PR]: 30-49% reduction; no response [NR]: <30% reduction; and qualitative [QR]: no reduction in frequency but decreased pain intensity), adverse effects (AE), discontinuation, discontinuation cause and treatment duration.Quantitative variables: mean±standard deviation (normal distribution), median and interquartile range (non-normal distribution), qualitative variables as frequencies. Differences among groups: Student’s T-test (quantitative variables, normal distribution), Mann-Whitney U test (quantitative variables, non-normal distribution), Pearson’s Chi-square/Fisher’s exact test (qualitative variables).Results 65 patients were included: 58 women (89.2%), age 43 years (IQR 33.0-51.0). 48 patients (73.8%) had MC and 17 (26.2%) ME-AF. They had 5.65±1.92 previous nonspecific treatments. 25 patients (38.5%) had used anti-CGRP antibodies. Treatment: 56 (82.6%) atogepant and nine (13.8%) rimegepant.Response rate: 18 (28.1%) had CR, six (9.4%) presented PR, 28 (43.7%) showed NR and 12 (18.8%) had QR. One patient discontinued treatment before evaluating response.Safety: 35 patients (53.8%) reported AEs 17 (48.6%) anorexia, 13 (37.1%) constipation, 14 (40.0%) nausea, four (11.4%) vomiting, three (8.6%) weight loss, two (5.7%) dizziness, four (11.4%) other digestive symptoms, and three (8.6%) central nervous system manifestations. 31 (47.7%) treatment discontinuations occurred: 23 (74.2%) due to ineffectiveness, six (19.4%) from AEs and two (6.5%) caused by pregnancy. Treatment duration, if discontinued for any reason, was 107±44.1 days.G1vs G2 showed statistically significant differences in gender (100% vs 82.5% women), migraine classification (HFEM 11.8% vs 88.2%; p=0.008) and number of previous nonspecific prophylactic treatments (6.4±2.31 vs 5.03±1.33; p=0.002). There were no statistically significant differences in response rate (CR 25.0% vs 30.0%; PR 0.0% vs 15.0%; NR 50.0% vs 40.0%; QR 25.0% vs 15.0%; p=0.178), in safety-related variables nor in the remaining variables studied.Conclusion and Relevance Almost a third of the patients showed complete response. Almost half of the patients, however, did not experience changes in migraine frequency or intensity. More than half of the patients suffered AEs, mostly digestive, being the most reported anorexia, constipation and nausea. There were no differences in response rate between the patients previously treated with anti-CGRP antibodies versus naïve.Conflict of Interest No conflict of interest",
  "authors": [
    {
      "affiliations": [
        "Hospital Universitario Infanta Leonor, Pharmacy, Madrid, Spain"
      ],
      "name": "L López"
    },
    {
      "affiliations": [
        "Hospital Universitario Infanta Leonor, Pharmacy, Madrid, Spain"
      ],
      "name": "I Cañamares Orbis"
    },
    {
      "affiliations": [
        "Hospital Universitario Infanta Leonor, Pharmacy, Madrid, Spain"
      ],
      "name": "S Esteban Casado"
    },
    {
      "affiliations": [
        "Hospital Universitario Infanta Leonor, Pharmacy, Madrid, Spain"
      ],
      "name": "C Esteban Alba"
    },
    {
      "affiliations": [
        "Hospital Universitario Infanta Leonor, Pharmacy, Madrid, Spain"
      ],
      "name": "S Prieto Román"
    },
    {
      "affiliations": [
        "Hospital Universitario Infanta Leonor, Pharmacy, Madrid, Spain"
      ],
      "name": "M Sánchez Lorenzo"
    },
    {
      "affiliations": [
        "Hospital Universitario Infanta Leonor, Pharmacy, Madrid, Spain"
      ],
      "name": "M Arce Sánchez"
    },
    {
      "affiliations": [
        "Hospital Universitario Infanta Leonor, Pharmacy, Madrid, Spain"
      ],
      "name": "I Escobar Rodríguez"
    }
  ],
  "title": "4CPS-269 Atogepant and rimegepant for migraine prevention: effectiveness and safety in clinical practice",
  "uid": "689b3e7a-ba86-52ed-9315-dc5ec74f93d8"
}