Study participants
The International Classification of Headache Disorders,
3rd edition (ICDH-3), defines chronic migraine
(CM) as headache of any duration or severity for ≥15 days/month for
>3 months, of which ≥8 or more are migrainous headache23, whereas latest guidelines categorize episodic
migraine (EM) as fewer than 14 migraine or headache days/month for
>3 months 24.
Inclusion criteria ̵̶ ˗. Only patients with chronic or episodic migraine
aged between 18 and 65 years who had received and failed at least three
or more oral preventive medication classes (β-blockers, antiepileptics,
calcium-antagonists, antidepressants, or angiotensin II receptor
antagonists (ARA-II)) due to lack of efficacy or intolerable side
effects were recruited. For patients suffering from CM, a failure or
partial response to current treatment with onabotulinumtoxinA treatment
was also requested. Patients who partially, but not totally, failed
still kept on treatment with either preventive oral therapies or
onabotulinumtoxinA as reported in the appendices section.
Exclusion criteria ̵̶̶̶ ̵̶. In line with available trials and previous
real-life studies, migraine patients with concomitant well-defined
psychiatric disorders (psychosis, bipolar disorders, or severe
depressive symptoms) were excluded from enrolment 25.
Loss to follow-up and non-utilization of the CGRP MoAbs were also
exclusion criteria.