4CPS-190 Analysis of ibrutinib dose reduction in patients diagnosed with chronic lymphocytic leukaemia: are we doing it right?

Abstract

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.