Albert Muñoz-Vendrell, Alba López-Bravo, Almudena Layos-Romero, Francisco J Alberola-Amores, María Obdulia Lozano Caballero, Antonio Sánchez-Soblechero, Cristian Morales-Hernández, María Victoria Castro-Sánchez, María Pilar Navarro-López, María Rocío Córdova-Infantes, Edoardo Caronna, Pablo Irimia, Alicia Gonzalez-Martinez
{"title":"抗cgrp单克隆抗体治疗65岁以上偏头痛患者的有效性和安全性:一项系统综述","authors":"Albert Muñoz-Vendrell, Alba López-Bravo, Almudena Layos-Romero, Francisco J Alberola-Amores, María Obdulia Lozano Caballero, Antonio Sánchez-Soblechero, Cristian Morales-Hernández, María Victoria Castro-Sánchez, María Pilar Navarro-López, María Rocío Córdova-Infantes, Edoardo Caronna, Pablo Irimia, Alicia Gonzalez-Martinez","doi":"10.1080/17581869.2025.2470615","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Migraine patients over 65 years have been excluded from pivotal anti-CGRP monoclonal antibody trials leaving limited real-life data on effectiveness and safety in this population. This review aims to summarize available evidence on treatment response and safety for older patients.</p><p><strong>Methods: </strong>A PubMed and Cochrane Controlled Register of Trials (CENTRAL) search identified studies on anti-CGRP monoclonal antibodies in patients with migraine over 65 up to October 2024. The review focuses on headache outcomes like reduction in monthly migraine days or monthly headache days, response rates (30%, 50%, 75%) and adverse effects of this specific population and/or against placebo, standard care, or younger patients. The quality of evidence was assessed using the GRADE tool.</p><p><strong>Results: </strong>All eligible studies were included, along with additional articles presented narratively. Data from clinical trials and post-hoc analyses show comparable efficacy and safety between older and younger patients. Similarly, early real-life studies support the use of anti-CGRP monoclonal antibodies in patients over 65 years, showing similar response rates, reductions in monthly migraine days and adverse effects.</p><p><strong>Discussion: </strong>Anti-CGRP monoclonal antibodies should likely be offered to patients over 65 although available evidence remains limited. Further studies analyzing specific data from this subgroup are necessary.</p>","PeriodicalId":20000,"journal":{"name":"Pain management","volume":"15 3","pages":"161-171"},"PeriodicalIF":1.4000,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11916378/pdf/","citationCount":"0","resultStr":"{\"title\":\"Effectiveness and safety of anti-CGRP monoclonal antibodies for migraine in patients over 65 years: a systematic review.\",\"authors\":\"Albert Muñoz-Vendrell, Alba López-Bravo, Almudena Layos-Romero, Francisco J Alberola-Amores, María Obdulia Lozano Caballero, Antonio Sánchez-Soblechero, Cristian Morales-Hernández, María Victoria Castro-Sánchez, María Pilar Navarro-López, María Rocío Córdova-Infantes, Edoardo Caronna, Pablo Irimia, Alicia Gonzalez-Martinez\",\"doi\":\"10.1080/17581869.2025.2470615\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Migraine patients over 65 years have been excluded from pivotal anti-CGRP monoclonal antibody trials leaving limited real-life data on effectiveness and safety in this population. This review aims to summarize available evidence on treatment response and safety for older patients.</p><p><strong>Methods: </strong>A PubMed and Cochrane Controlled Register of Trials (CENTRAL) search identified studies on anti-CGRP monoclonal antibodies in patients with migraine over 65 up to October 2024. The review focuses on headache outcomes like reduction in monthly migraine days or monthly headache days, response rates (30%, 50%, 75%) and adverse effects of this specific population and/or against placebo, standard care, or younger patients. The quality of evidence was assessed using the GRADE tool.</p><p><strong>Results: </strong>All eligible studies were included, along with additional articles presented narratively. Data from clinical trials and post-hoc analyses show comparable efficacy and safety between older and younger patients. Similarly, early real-life studies support the use of anti-CGRP monoclonal antibodies in patients over 65 years, showing similar response rates, reductions in monthly migraine days and adverse effects.</p><p><strong>Discussion: </strong>Anti-CGRP monoclonal antibodies should likely be offered to patients over 65 although available evidence remains limited. Further studies analyzing specific data from this subgroup are necessary.</p>\",\"PeriodicalId\":20000,\"journal\":{\"name\":\"Pain management\",\"volume\":\"15 3\",\"pages\":\"161-171\"},\"PeriodicalIF\":1.4000,\"publicationDate\":\"2025-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11916378/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Pain management\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1080/17581869.2025.2470615\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/3/3 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q4\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pain management","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1080/17581869.2025.2470615","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/3/3 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Effectiveness and safety of anti-CGRP monoclonal antibodies for migraine in patients over 65 years: a systematic review.
Background: Migraine patients over 65 years have been excluded from pivotal anti-CGRP monoclonal antibody trials leaving limited real-life data on effectiveness and safety in this population. This review aims to summarize available evidence on treatment response and safety for older patients.
Methods: A PubMed and Cochrane Controlled Register of Trials (CENTRAL) search identified studies on anti-CGRP monoclonal antibodies in patients with migraine over 65 up to October 2024. The review focuses on headache outcomes like reduction in monthly migraine days or monthly headache days, response rates (30%, 50%, 75%) and adverse effects of this specific population and/or against placebo, standard care, or younger patients. The quality of evidence was assessed using the GRADE tool.
Results: All eligible studies were included, along with additional articles presented narratively. Data from clinical trials and post-hoc analyses show comparable efficacy and safety between older and younger patients. Similarly, early real-life studies support the use of anti-CGRP monoclonal antibodies in patients over 65 years, showing similar response rates, reductions in monthly migraine days and adverse effects.
Discussion: Anti-CGRP monoclonal antibodies should likely be offered to patients over 65 although available evidence remains limited. Further studies analyzing specific data from this subgroup are necessary.