Belvís, RobertIrimia, PabloPozo-Rosich, PatriciaGonzález-Oria, CarmenCano, AntonioViguera, JavierSánchez, BelénMolina, FranciscoBeltrán, IsabelOterino, AgustínCuadrado, ElisaGómez-Camello, AngelAlberte-Woodward, MiguelJurado, CarmenOms, TeresaEzpeleta, Davidde Terán, Javier DíazMorollón, NoemíLatorre, GermánTorres-Ferrús, MartaAlpuente, AliciaLamas, RaquelToledano, CarlosLeira, RogelioSantos, SoniaDel Río, Margarita Sánchez2023-02-092023-02-092021-07-17http://hdl.handle.net/10668/18210Erenumab was approved in Europe for migraine prevention in patients with ≥ 4 monthly migraine days (MMDs). In Spain, Novartis started a personalized managed access program, which allowed free access to erenumab before official reimbursement. The Spanish Neurological Society started a prospective registry to evaluate real-world effectiveness and tolerability, and all Spanish headache experts were invited to participate. We present their first results. Patients fulfilled the ICHD-3 criteria for migraine and had ≥ 4 MMDs. Sociodemographic and clinical data were registered as well as MMDs, monthly headache days, MHDs, prior and concomitant preventive treatment, medication overuse headache (MOH), migraine evolution, adverse events, and patient-reported outcomes (PROs): headache impact test (HIT-6), migraine disability assessment questionnaire (MIDAS), and patient global improvement change (PGIC). A > 50% reduction of MMDs after 12 weeks was considered as a response. We included 210 patients (female 86.7%, mean age 46.4 years old) from 22 Spanish hospitals from February 2019 to June 2020. Most patients (89.5%) suffered from chronic migraine with a mean evolution of 8.6 years. MOH was present in 70% of patients, and 17.1% had migraine with aura. Patients had failed a mean of 7.8 preventive treatments at baseline (botulinum toxin type A-BoNT/A-had been used by 95.2% of patients). Most patients (67.6%) started with erenumab 70 mg. Sixty-one percent of patients were also simultaneously taking oral preventive drugs and 27.6% were getting simultaneous BoNT/A. Responder rate was 37.1% and the mean reduction of MMDs and MHDs was -6.28 and -8.6, respectively. Changes in PROs were: MIDAS: -35 points, HIT-6: -11.6 points, PIGC: 4.7 points. Predictors of good response were prior HIT-6 score  In real-life, in a personalized managed access program, erenumab shows a good effectiveness profile and an excellent tolerability in migraine prevention in our cohort of refractory patients.enAttribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/ErenumabMigraineMonoclonal antibodyPreventive treatmentRegistryAntibodies, Monoclonal, HumanizedEuropeFemaleHumansMiddle AgedMigraine DisordersRegistriesSpainresearch article34273947open access10.1186/s10194-021-01267-x1129-2377PMC8285868https://thejournalofheadacheandpain.biomedcentral.com/counter/pdf/10.1186/s10194-021-01267-xhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8285868/pdf