Edoardo Caronna, Rut Mas-de-les-Valls, Gabriella Egeo, M. Millán Vázquez, Candela Nieves-Castellanos, Leonardo Portocarrero-Sánchez, Gloria Vaghi, Joana Rodríguez-Montolio, as the European Real-World Study on the Use of Anti-CGRP Monoclonal Antibodies in Migraine (EUREkA) Study Group, Alex Jaimes, Albert Muñoz-Vendrell, Renato Oliveira, Marcos Polanco, Yésica González Osorio, Javiera Canales, Raffaele Ornello, Cem Thunstedt, Iris Fernández-Lázaro, Andreas Husøy, Antonio Sánchez-Soblechero, Beatriz Nunes Vicente, Nuria Riesco, Belen Flores Pina, Catarina Fernandes, Alberto Andrés López, Elisa Martins-Silva, Sławomir Budrewićz, Víctor José Gallardo, Laura Gómez Dabó, Marta Torres-Ferrus, Alicia Alpuente, Paola Torelli, Cinzia Aurilia, Raquel Lamas, Maria José Ruiz Castrillo, R. De Icco, Grazia Sances, Sarah Broadhurst, Jed Winstanley, Andrea Gómez, Sergio Campoy, Inês Brás Marques, Elsa Parreira, Gabriel Henríquez Gárate, Julio Pascual, Angel Luis Guerrero Peral, Valeria Caponnetto, Andreas Straube, Alicia Gonzalez-Martinez, S. Quintas, Margarita Sanchez-Del-Rio, Erling Tronvik, B. Rupérez Pérez, Agustín Oterino Duran, Miguel K. Rodrigues, Sabina Cevoli, Bruno Colombo, Michele Trimboli, Fabio Frediani, Florindo d'Onofrio, Marco Aguggia, Antonio Salerno, Antonio Carnevale, Maurizio Zucco, Maria Albanese, Cinzia Finocchi, Angelo Ranieri, Francesco Zoroddu, Massimo Autunno, Jordi Sanahuja, Marta Waliszewska-Prosół, Liliana Pereira, Almudena Layos-Romero, Isabel Luzeiro, Laura Dorado, Rocío Álvarez-Escudero, Isabel Pavão Martins, Christina Sundal, Pablo Irimia, Alberto Lozano Ros, Ana Beatriz Gago-Veiga, Fernando Velasco Juanes, Ruth Ruscheweyh, Simona Sacco, David García-Azorín, Vicente González-Quintanilla, Raquel Santos Gil-Gouveia, Mariano Huerta Villanueva, Jaime Rodríguez-Vico, S. Santos- Lasaosa, Mona Ghadri-Sani, C. Tassorelli, Francisco Javier Díaz De Terán Velasco, Samuel Diaz-Insa, C. González Oria, Piero Barbanti, Patricia Pozo-Rosich
ObjectivesThe aim of this study was to describe the long-term effectiveness and treatment persistence of anti–calcitonin gene-related peptide (CGRP) monoclonal antibodies (MAbs) in migraine and to identify baseline factors associated with 2-year treatment continuation. MethodsA prospective observational multicenter registry-based study of anti-CGRP MAbs was conducted. We analyzed changes in monthly headache days (MHDs) at 24 months (M24) compared with baseline in those who reached M24 (ON-group). We analyzed patterns of response at 4 time points (6, 12, 18, and 24 months). We defined sustained response (SR) as a ≥50% reduction in MHDs at ≥3 of 4 time points. We compared baseline characteristics of the ON-group with those of the discontinuation group because of lack of effectiveness (OFF-group). ResultsA total of 1,340 individuals reached M24 (ON-group: median age 48.0 [41.0–55.0] years; 81.7% female). The median MHD at baseline was 20.0 (13.0–28.0) days. At M24, 60.4% of patients demonstrated ≥50% reduction in MHDs (809/1,340). The proportion of participants achieving SR at M24 was 53.8% (142/264). When compared with the ON-group (n = 1,340), the OFF-group (n = 1,057) showed statistically significant higher baseline MHDs (ON: 20.0 [13.0–28.0] vs OFF: 25.0 [16.0–28.0]) and a greater proportion of patients with aura (ON: 16.2% vs OFF: 22.9%), depression (ON: 22.8% vs OFF: 37.9%), and obesity (ON: 7.2% vs OFF: 19.1%) (p < 0.001). DiscussionSustained reductions in MHDs to anti-CGRP treatment at 2 years was observed. Delayed treatment onset, migraine with aura, depression, and obesity may negatively affect treatment persistence. Classification of EvidenceThis study provides Class IV evidence that, in patients with migraine, treatment with anti-CGRP MAbs is associated with sustained reductions in MHDs over a 24-month period.