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Background and Importance Monoclonal antibodies targeting the calcitonin gene-related peptide (anti-CGRP) are recently available for migraine treatment. Real-world data on the utilisation of these drugs in clinical practice is scarce, but this information could help hospital pharmacists afford a better selection of the available drugs. Aim and ObjectivesThe study aimed to explore differences in medication persistence in patients with migraine treated with erenenumab, a human monoclonal antibody that binds to the receptor for CGRP, or fremanezumab and galcanezumab, humanised monoclonal antibodies that bind CGRP. Material and Methods RPT is a drug registry of patients with migraine initiating biologic treatment in public university hospitals in Catalonia. For this study, we retrieved from the registry data of patients initiating treatment after 01/02/2020 with erenumab, fremanezumab or galcanezumab. The primary outcomes assessed were: gender, age, discontinuation rate, time to discontinuation, and the causes of it. We also collected data to measure the treatment response, such as migraine days per month and the validated quality of life scales (Migraine Disability Assessment Scale and Headache Impact Test-6).Retrieved data was dissociated before any analysis. Chisquare was used to compare proportions and t-Student for continuous variables. Results Data from 131 patients was retrieved: 55/131 were treated with erenumab and 76/131 with galcanezumab/fremanezumab. 85% of patients were women, with a median age of 51. Medication persistence three months after initiating treatment was 36/55 with erenumab and 57/76 with fremanezumab/galcanezumab. There were no significant differences between the two mechanisms of action.The mean time to discontinuation in patients treated with erenumab was 8,9 months and in patients treated with fremanezumab or galcanezumab, 6,8 months, without significant differences.2/19 and 3/19 patients discontinued treatment due to toxicity with erenumab and fremanezumab/galcanezumab, respectively.30/131 patients' treatment were switched to a different mechanism of action. A three-month follow-up after the treatment change revealed significant improvement in 15/30 patients. Conclusion and RelevanceMedication persistence in migraine treatment with anti-CGRP monoclonal antibodies seems similar for both mechanisms of action.More extensive studies are needed to clarify the difference in response to different anti-CGRP monoclonal antibodies.

Background Oral chemotherapy against metastatic or advanced renal-cell carcinoma (mRCC) is currently benefiting from a wide range of possibilities. Purpose To analyse the effectiveness of the actual therapy for the treatment of the mRCC in real conditions based on survival at one and two years and modifications in dosage or drug. Materials and methods Retrospective evaluation of clinical history from November 2011 to September 2013. In our hospital tyrosine kinase inhibitors were the first line treatment and mTOR inhibitors were the second line. Results 68 patients were treated for mRCC. Male/Female: 73/27. Average age: 64.6 years. After 1 year of treatment 81.4% patients survived (22/27) and 42.8% after two years (3/7). 44/68 patients (65%), needed a drug change due to progression. Average time to change was 6.4 months (59% CL: 4.6–8.1) (median: 5.1). 8/68 (11.7%) required a treatment change towards a third line. Of these 8 patients; 3 restarted treatment with sunitinib as fourth line. Out of 41 patients who initiated therapy with sunitinib 50 mg once daily on schedule 4–2; 19 patients (46.3%) needed a descending adjustment of the dose. The average time to dose adjustment was 4.2 months (59% CL: 2.6–5.7) Conclusions Oral treatment of advanced renal cancer has several therapeutic possibilities; which must be treated with rigorous criterion in favour of the clinical benefit applying the maximum efficiency. Even limited by the small sample size, the results are similar to those previously reported in this setting. First year survival rate: 81.4% vs. 75%1 Second year survival rate: 42.8% vs. 50%1 Of the 68 patients studied, 65% required a drug change during their treatment mostly due to loss of efficacy. Sunitinib 50 mg 4–2 schedule dose adjustment: 46.3% vs. 46%2 (33% + 13%) Time to dose adjustment: 4.2 months versus 7.5 months2 References RJ Motzer, B Escudier, R Bukowski, et al. Prognostic factors for survival in 1059 patients treated with sunitinib for metastatic renal cell carcinoma. British Journal of Cancer 2013;108:2470-2477 Martin E Gore, Cezary Szczlik, Camillo Porta, et al. Safety and efficacy of sunitinib for metastatic renal-cell carcinoma: an expanded-access trial. Lancet Oncol 2009;10:757-63 No conflict of interest.

Background Multiple myeloma (MM) is a malignant monoclonal gammapathy that occurs mainly in patients over 65 years. Lenalidomide is indicated in combination with dexamethasone for the treatment of MM in patients who have received at least one prior treatment regimen. All this makes it likely the patient will require Pharmaceutical Care (PC). PC consists of collaboration with other health professionals and with the patient to design a safe and effective treatment plan, as well as to identify Drug Related Problems (DRPs) and to resolve and prevent negative outcomes associated with medication (RNMs). Purpose To evaluate the impact of pharmaceutical intervention in patients diagnosed with MM treated with lenalidomide in a pharmacists-led haematological consultation within the Pharmacy Service. Materials and MethodsQuasi-experimental study of 4 months duration on patients diagnosed with MM treated with lenalidomide. Clinical practise follow-up procedures used the Dader method adapted to the study situation. Data were obtained from interviews with patients, electronic medical records and Outpatient Service Pharmacy records. Results During this period, 29 patients were diagnosed with MM and treated with lenalidomide, 21 joined the study (4 didn’t gave consent and 2 weren’t able to visit the pharmacy), 11 women and 10 men. Average age: 70.3 years (52–89). During study a total of 17 DRPs were detected: 4 related to the indication, 1 to the effectiveness and 8 to the safety, and a total of 35 RNMs: 4 related to the need, 5 to the effectiveness and 26 to the safety. Of these 35, 45.7% could have been avoided. A total of 25 pharmaceutical interventions were made: 10 related to the amount of drug, 9 to the pharmacological strategy and 6 to patient education. Conclusions A variety of goals were achieved through pharmaceutical interventions: medicines reconciliation, resolution of health problems by detecting RNMs and avoidance of RNMs by detecting DRPs. No conflict of interest.

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