000161669 001__ 161669
000161669 005__ 20251017144612.0
000161669 0247_ $$2doi$$a10.1007/s00415-025-13177-y
000161669 0248_ $$2sideral$$a144321
000161669 037__ $$aART-2025-144321
000161669 041__ $$aeng
000161669 100__ $$aGarcía-Castillo, María Clara
000161669 245__ $$aConcomitant anti-CGRP and immunomodulatory treatments in patients with migraine: towards integrated management strategies
000161669 260__ $$c2025
000161669 5060_ $$aAccess copy available to the general public$$fUnrestricted
000161669 5203_ $$aPreclinical evidence supports the immunoregulatory role of calcitonin gene-related peptide (CGRP) in migraine pathophysiology. The increasing use of anti-CGRP therapies in patients with migraine and other comorbidities raises the question whether the potential use of anti-CGRP monoclonal antibodies (CGRP-mAbs) therapies in combination with other immunological therapies is effective and safe.
Methods. This multicenter study included patients with migraine receiving CGRP-mAbs combined with immunosuppressive and immunomodulatory treatments. Clinical and demographic data, treatment history, laboratory markers and treatment-emergent adverse events (TEAEs) were analyzed. Effectiveness outcomes included the change in monthly migraine days (MMD) and monthly headache days (MHD) at 3, 6, 9 and 12 months, alongside the > 50% response rate. Moreover, autoimmune disease progression was also evaluated. We explored differences between patients with and without autoimmune disease activation.
Results.Among 89 patients, there were 80 (90%) females with a mean age of 50 years (SD: 11), who had a high prevalence of psychiatric comorbidities (anxiety 44%, depression 49%) and medication overuse (68%). Patients receiving immunological treatments experienced significant reductions in MMD and MHD, with MMD decreasing from 16 (SD: 7) at baseline to 9 (SD: 8) at 6 months, and MHD dropping from 23 (SD: 8) to 17 (SD: 11). A 50% response in MMD was achieved by 46% at 6 months. TEAEs were reported in 28%, most commonly constipation (16%) and dizziness (9%).
Conclusions. CGRP-mAbs therapies combined with immunological treatments appear effective and safe in patients with autoimmune diseases. Larger prospective studies are necessary to confirm these findings and optimize management strategies.
000161669 536__ $$9info:eu-repo/grantAgreement/ES/ISCIII/CM21-00178$$9info:eu-repo/grantAgreement/ES/ISCIII/JR23/0005$$9info:eu-repo/grantAgreement/ES/ISCIII/PI24-01085
000161669 540__ $$9info:eu-repo/semantics/openAccess$$aby$$uhttps://creativecommons.org/licenses/by/4.0/deed.es
000161669 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000161669 700__ $$aSierra-Mencía, Álvaro
000161669 700__ $$aCaronna, Edoardo
000161669 700__ $$aToledo-Alfocea, Daniel
000161669 700__ $$aJaimes, Alex
000161669 700__ $$aUrtiaga, Saray
000161669 700__ $$aCasas-Limón, Javier
000161669 700__ $$aMuñoz-Vendrell, Albert
000161669 700__ $$0(orcid)0000-0001-5139-6031$$aSantos Lasaosa, Sonia$$uUniversidad de Zaragoza
000161669 700__ $$aGarcía Martín, Valvanuz
000161669 700__ $$aMartín Ávila, Guillermo
000161669 700__ $$aPolanco, Marcos
000161669 700__ $$aVillar-Martínez, Maria Dolores
000161669 700__ $$aTrevino-Peinado, Cristina
000161669 700__ $$aRubio-Flores, Laura
000161669 700__ $$aSánchez-Soblechero, Antonio
000161669 700__ $$aPortocarrero Sánchez, Leonardo
000161669 700__ $$aLuque-Buzo, Elisa
000161669 700__ $$aLozano-Ros, Alberto
000161669 700__ $$aGago-Veiga, Ana Beatriz
000161669 700__ $$aDíaz-De-Terán, Javier
000161669 700__ $$aRecio García, Andrea
000161669 700__ $$aCanales Rodríguez, Javiera
000161669 700__ $$aGómez García, Andrea
000161669 700__ $$aGonzález Salaices, Marta
000161669 700__ $$aCampoy, Sergio
000161669 700__ $$aMínguez-Olaondo, Ane
000161669 700__ $$aManiataki, Stefania
000161669 700__ $$aGonzález-Quintanilla, Vicente
000161669 700__ $$aPorta-Etessam, Jesús
000161669 700__ $$aCuadrado, María-Luz
000161669 700__ $$aGuerrero Peral, Ángel Luis
000161669 700__ $$aPozo-Rosich, Patricia
000161669 700__ $$aRodríguez-Vico, Jaime
000161669 700__ $$aHuerta-Villanueva, Mariano
000161669 700__ $$aPascual, Julio
000161669 700__ $$aGoadsby, Peter J.
000161669 700__ $$aGonzalez-Martinez, Alicia
000161669 7102_ $$11007$$2610$$aUniversidad de Zaragoza$$bDpto. Medicina, Psiqu. y Derm.$$cArea Medicina
000161669 773__ $$g272, 6 (2025), 12 pp.$$pJ. neurol.$$tJournal of Neurology$$x0340-5354
000161669 8564_ $$s793323$$uhttps://zaguan.unizar.es/record/161669/files/texto_completo.pdf$$yVersión publicada
000161669 8564_ $$s2523026$$uhttps://zaguan.unizar.es/record/161669/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000161669 909CO $$ooai:zaguan.unizar.es:161669$$particulos$$pdriver
000161669 951__ $$a2025-10-17-14:17:56
000161669 980__ $$aARTICLE