Introducción Establecer si determinados rasgos de personalidad podrían predecir la respuesta a los anticuerpos monoclonales (AcM) frente al péptido relacionado con el gen de la calcitonina (CGRP) en pacientes con migraña. Método Estudio observacional con diseño de cohortes prospectiva. Pacientes con migraña crónica (MC) o episódica de alta frecuencia (MEAF) tratados de acuerdo con los criterios nacionales de reembolso con AcM frente al CGRP en una unidad de cefaleas de un hospital terciario. Se recabaron variables clínicas y demográficas. Se consideró respuesta la reducción de al menos un 50% en el número de días al mes de cefalea a los 3meses de tratamiento. Se administró el test de Salamanca para evaluar los rasgos de personalidad. Resultados Se incluyeron 104 pacientes, 88 (84,6%) mujeres con 46,5±10,3 años en el momento del inicio del tratamiento. En 88 (84,6%), diagnóstico de MC. Tratamiento con galcanezumab y fremanezumab (52 casos cada fármaco). Respuesta en 75 pacientes (72,1%). En el grupo de pacientes respondedores se observó menor edad al inicio del tratamiento (44,1±10,6 vs 49,7±9,1, p= 0,006), menor latencia en años inicio migraña-tratamiento (22,4±12,2 vs 28,2±14,4, p=0,029) y menor latencia en meses inicio MC o MEAF-tratamiento (90,4±51,9 vs 118,5±61,2, p=0,013). Los rasgos de personalidad más presentes en la muestra fueron: histriónico (64,4%), anancástico (52,9%) y ansioso (50%). Predijo la ausencia de respuesta al tratamiento la presencia del rasgo inestabilidad emocional subtipo límite (OR: 0,24 [0,09-0,64]). Conclusiones Los rasgos de personalidad, junto a otras variables clínicas y demográficas, pueden ser factores predictores de respuesta al tratamiento con AcM frente al CGRP.

INTRODUCTION:The purpose of this study is to determine whether certain personality traits may predict response to anti-calcitonin gene-related peptide (anti-CGRP) monoclonal antibodies (mAb) in patients with migraine. METHODS:We conducted an observational, prospective study of a cohort of patients with chronic migraine (CM) or high-frequency episodic migraine (HFEM) treated with anti-CGRP mAbs according to Spanish national healthcare system reimbursement criteria at the headache unit of a tertiary hospital. We gathered clinical and demographic data. Treatment response was defined as a ≥ 50% decrease in the number of headache days per month at 3 months of treatment. The Salamanca Screening Test was used to evaluate personality traits. RESULTS:We included 104 patients, 88 of whom were women (84.6%), with a mean age (standard deviation) of 46.5 years (10.3) at treatment onset. A total of 88 patients (84.6%) had a diagnosis of CM. Fifty-two patients received galcanezumab and the remaining 52 were treated with fremanezumab. Response was achieved in 75 patients (72.1%). Compared to non-responders, responders presented a younger age at treatment onset (44.1 [10.6] vs 49.7 [9.1]; P =  .006), shorter latency from migraine onset to treatment onset (22.4 [12.2] vs 28.2 [14.4] years; P =  .029), and shorter latency from CM or HFEM diagnosis to treatment onset (90.4 [51.9] vs 118.5 [61.2] months; P = .013). The most prevalent personality traits in our sample were histrionic (64.4%), anankastic (52.9%), and anxious (50%). Borderline personality was found to predict lack of response to treatment (OR = 0.24 [0.09-0.64]). CONCLUSIONS:Personality traits, along with other clinical and demographic variables, may predict response to treatment with anti-CGRP mAbs in patients with migraine.

BACKGROUND:Patients' knowledge about their medications is key to guarantee therapeutic compliance in chronic diseases. AIMS OF THE STUDY:To determine patients' knowledge of oral preventive treatment (OPT) in migraine. METHODS:This is a cross-sectional study evaluating knowledge of medication with a validated questionnaire that assessed: therapeutic objective, process of use, safety and conservation. RESULTS:198 patients were included. Mean age was 45.4 ± 11.5 years-old and 92.4% were women. A 61.1% of migraine patients did not know the medication they used, 55.1% showed insufficient knowledge and 6.1% had no knowledge. The most known dimension was conservation (80.3%) and the most unknown dimension of was safety (33.7%). In this regard, 82.3% considered that they should not take precautions when taking the treatment, 80.3% stated that it had no contraindications and 82.8% were unaware of possible interactions with other medications. Worse knowledge about OPT was associated with longer time since migraine onset (p = .049), higher scores on the Hospital Anxiety and Depression Scale (p = .021), less qualified jobs (p = .045), use of monotherapy (p = .001) and longer periods since OPT initiation (p = .013). CONCLUSIONS:The majority of migraine patients did not adequately know their preventive treatment, despite identifying some of the items related to their medication. The present study shows that knowledge of patients about their preventive treatment should be evaluated in clinical practice and could help migraine patients in the correct use of OPT.