Effectiveness and safety of anti-CGRP monoclonal antibodies in patients over 65 years: a real-life multicentre analysis of 162 patients

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 10.17.3 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

El actor y el público: los olvidados

En primer lugar habría que señalar la importancia de este coloquio por su tema, puesto que traduce una sensibilidad que se acrecentará en los próximos años y conducirá al tratamiento de todos y cada uno de los elementos constituyentes del hecho teatral. Es necesario aclarar, por otra parte, que el presente texto no tiene carácter de trabajo acabado – todo lo contrario – no es sino un comienzo, una suerte de invitación a la participación a un trabajo de investigación que comenzó hace muchos, m..

El actor ante los poderes

Nuestra intervención está centrada en uno de los componentes del hecho treatral que consideramos como aquel que preocupa en menor grado a los estudiosos: el actor. Ya habíamos señalado en el coloquio de 1996, que para que exista el teatro, acabado, la acción o espectáculo, sólo dos componentes son imprescindibles: el actor y el público. Ciertamente desde el punto de vista histórico y en el espacio de todos los continentes ha existido una gran diversidad de « teatros », y en este siglo paulati..

Inteligencia artificial en migraña y otras cefaleas

La inteligencia artificial (IA) puede ser de gran utilidad en el diagnóstico de los distintos tipos de cefalea gracias a herramientas automatizadas basadas en los actuales criterios diagnósticos que faciliten el cribado de los pacientes hacia niveles de atención médica más o menos especializada. La IA también puede facilitar la detección precoz de las crisis de dolor mediante su uso combinado con dispositivos portátiles. Por último, la IA permite detectar factores predictores de respuesta a tratamientos al identificar patrones y correlaciones. Todo ello hace de la IA una herramienta prometedora y útil para mejorar la atención médica y la calidad de vida de los pacientes con cefalea de forma complementaria al método clínico clásico

Effectiveness and safety of anti-CGRP monoclonal antibodies in patients over 65 years: a real-life multicentre analysis of 162 patients

Abstract 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 Abstrac

Théâtre, public, société

Actes du IIIe Colloque International sur le théâtre, domaines hispanique, hispano-américain et mexicain, en France, organisé les 10, 11 et 12 octobre 1996 à l’Université de Perpignan, par le Centre de Recherches Ibériques et Latino-américaines de l’Université de Perpignan (CRILAUP), le Département d’Etudes Hispaniques de l’Université de Perpignan et la Faculté des Lettres et Sciences Humaines de l’Université de Perpignan

Théâtre et pouvoir

Actes du IVe Colloque International sur le théâtre, domaines hispanique, hispano-américain et mexicain, en France, organisé les 8, 9 et 10 octobre 1998 à l’Université de Perpignan, par le Centre de Recherches Ibériques et Latino-américaines de l’Université de Perpignan