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Abstract Details

Single Center Experience of mAbs-CGRP Use for Migraine Prevention
Headache Posters (7:00 AM-5:00 PM)
mAbs-CGRP (Erenumab, Galcanezumab, and Fremanezumab) were FDA approved for migraine prevention in 2018.  Since these medications are only on the market for less than 2 years, post market data on their use and efficacy was lacking.  In this study, we present our own headache center’s experience with the use of mAbs-CGRP.
To describe the use, efficacy, and tolerability of monoclonal antibodies against calcitonin gene-related peptide (CGRP) or CGRP receptor (mAbs-CGRP) for migraine medications in our headache center.
A retrospective chart review of a single center database was conducted to find all patients initiated on a mAb-CGRP since 2018.  Information on mAb use, efficacy and tolerability were collected. Also, concomitant OnabotulinumtoxinA use was collected.
We identified 85 patients who started on mAb-CGRP.  44 (55%) had good migraine controlled on their first choice of mAb-CGRP; 33 (39%) stopped due to lack of efficacy. Of those who stopped, 31 (91%) moved onto a second mAb-CGRP.  Average time to failure (TTF) for first medication was 203 days (range 32-723 days).  21 (70%) out of 31 patients continued onto a second mAb-CGRP had their migraines well controlled; 9 (30%) stopped due to lack of efficacy. Average TTF for second medication was 247 days (range 46-529 days). 5 out of 9 patients who stopped their second mAb-CGRP were put on a third mAb-CGRP. All 5 patients’ migraines were well controlled on their third medication. 55 out of the 85 patients (65%) were also on OnabotulinumtoxinA injection regimen for migraine prevention.
70 of the 85 patients (82%) were able to tolerate use of mAbs-CGRP with some efficacy. Reasons for stopping included medication failure, adverse effects, and insurance difficulties. Combined use of mAb and OnabotulinumbtoxinA seemed to be a safe and efficacious treatment of migraine. 
Christopher Joseph Bondoc, MD (True North Neurology)
Dr. Bondoc has nothing to disclose.
Jin Li, MD, PhD, FAAN Dr. Li has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Abbvie. Dr. Li has a non-compensated relationship as a member, woman leadership committee with AAN that is relevant to AAN interests or activities.