TOPLINE:

Galcanezumab appeared to be as equally effective and well tolerated in older patients (aged ≥ 65 years) with migraine as in younger patients (aged < 65 years), with older patients achieving higher rates of excellent response to the treatment.

METHODOLOGY:

• Researchers conducted a prospective multicentre cohort study to evaluate the effectiveness and tolerability of galcanezumab in patients with migraine.
• They included 1055 patients (n = 934 aged < 65 years; n = 121 aged ≥ 65 years; 82.9% women) with chronic or high-frequency episodic migraine who did not respond to three or more preventive drugs, were treated with galcanezumab, and were followed up for 12 months.
• The effectiveness (≥ 50% reduction in the number of monthly headache days [MHDs]), excellent response (≥ 75% reduction in the number of MHDs), and tolerability (discontinuation due to adverse events) of galcanezumab were assessed at 3, 6, and 12 months.

TAKEAWAY:

• During follow-up, no significant differences in the effectiveness of galcanezumab were observed between older and younger patients at 3, 6, and 12 months.
• A higher proportion of patients aged 65 years or older achieved an excellent response to the treatment than those younger than 65 years at 3 months (32.2% vs 23.1%; P = .028) and 6 months (33.9% vs 23.5%; P = .012). The difference was not statistically significant at 12 months.
• Overall, 5.8% of patients aged 65 years or older and 6.7% of those younger than 65 years discontinued treatment due to adverse effects, with no statistically significant difference in tolerability seen between the age groups.
• At 6 months, age was independently associated with treatment effectiveness (adjusted odds ratio [aOR], 1.02; P = .008) and excellent response (aOR, 1.02; P < .001).

IN PRACTICE:

"[The study] finding, added to the favorable effectiveness and tolerability profile already evidenced, makes galcanezumab an excellent choice for the preventive treatment of migraine in people age ≥ 65 years," the authors wrote.

SOURCE:

This study was led by Julia Peris-Subiza, MD, Neurology Department, Department of Medicine and Life Sciences, Hospital del Mar Barcelona, Universitat Pompeu Fabra, Barcelona, Spain. It was published online on October 14, 2025, in Headache: The Journal of Head and Face Pain.

LIMITATIONS:

This study included a relatively low number of patients older than 65 years. It lacked data on patients with migraine with aura. This study included data on cardiovascular risk factors only for older patients, not for younger patients.

DISCLOSURES:

This study did not receive any specific grant from any funding source. Several authors reported receiving speaker fees/travel grants or participating in clinical trials of various pharmaceutical companies.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.