2026-04-05T10:52:44Zhttps://recercat.cat/oai/request

oai:recercat.cat:2445/2222762025-12-05T01:21:40Zcom_2072_1057col_2072_478916col_2072_478917

Concomitant anti-CGRP and immunomodulatory treatments in patients with migraine: towards integrated management strategies García Castillo, María Clara Sierra Mencía, Álvaro Caronna, Edoardo Toledo Alfocea, Daniel Jaimes, Alex Urtiaga, Saray Casas Limón, Javier Muñoz Vendrell, Albert Santos Lasaosa, Sonia García Martín, Valvanuz Martín Ávila, Guillermo Polanco, Marcos Villar Martínez, María Dolores Trevino Peinado, Cristina Rubio Flores, Laura Sánchez Soblechero, Antonio Portocarrero Sánchez, Leonardo Luque Buzo, Elisa Lozano Ros, Alberto Gago Veiga, Ana Beatriz Díaz de Terán, Javier Recio García, Andrea Canales Rodríguez, Javiera Gómez García, Andrea González Salaices, Marta Campoy Diaz, Sergio Mínguez Olaondo, Ane Maniataki, Stefania González Quintanilla, Vicente Porta Etessam, Jesús Cuadrado, María Luz Guerrero Peral, Ángel Luis Pozo Rosich, Patricia Rodríguez Vico, Jaime Huerta Villanueva, Mariano Pascual, Julio Goadsby, Peter J. González Martínez, Alicia Migranya Immunofarmacologia Migraine Immunopharmacology Background Preclinical 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. 2025-07-16T09:06:41Z 2025-07-16T09:06:41Z 2025-06-03 2025-07-14T10:31:08Z info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Reproducció del document publicat a: https://doi.org/10.1007/s00415-025-13177-y Journal of Neurology, 2025, vol. 272, num. 6, 443 https://doi.org/10.1007/s00415-025-13177-y cc-by (c) García Castillo, María Clara et al., 2025 http://creativecommons.org/licenses/by/3.0/es/ info:eu-repo/semantics/openAccess Springer Science and Business Media LLC Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))