4CPS-030 Real-world longitudinal outcomes of preventive treatments targeting the CGRP pathway in migraine: hit-6 and midas responder analysis according to the minimal clinically important difference (MCID)

<h3>Background and Importance</h3> Patient-reported outcome measures (PROMs) are essential to evaluate the real-world impact of preventive therapies in migraine. Minimal clinically important difference (MCID) thresholds allow the identification of meaningful improvements, yet their longitudinal evolution in clinical practice remains underexplored. <h3>Aim and Objectives</h3> To assess the proportion of patients achieving clinically meaningful improvements in HIT-6 (≥3 points) and MIDAS (≥4.5 points) over 24 months in a real-world migraine cohort, and to characterise patient demographics and treatment exposure. <h3>Material and Methods</h3> Prospective observational stud in patients with preventive treatments targeting the CGRP pathway were included . PROMs were collected remotely via a telepharmacy platform at baseline and follow-up (1, 3, 6, 12 and 24 months). . Responder analysis was conducted in patients with paired baseline–follow-up data. Responders were defined as ≥3-point reduction in HIT-6 or ≥4.5-point reduction in MIDAS. Proportions of responders were calculated at each timepoint; Chi-squared tests assessed differences across visits. <h3>Results</h3> A cohort of 244 patients with migraine from 10 centres was followed Mean age was 45.2 years (SD 12.3; range 18.0–75.0; IQR 37.0–54.0); 82.1% were women. 55% of ePROMs were completed. Patients received the following CGRP pathway-targeted preventive treatments: 32.4% galcanezumab, 28.1% erenumab, 24.3% fremanezumab, 8.2% atogepant, 2.5% eptinezumab, 4.5% others. The overall response rate to ePROMs was 54.8%. HIT-6 responders: 1m 54.8% , 3m 63.6%, 6m 70.7% , 12m 66.7% , 24m 70.4%. MIDAS responders: 1m 62.1% , 3m 66.0% (68/103), 6m 71.0% , 12m 68.3% , 24m 68.0%. Responder rates remained stable over time, with no statistically significant differences across visits (HIT-6: χ²=6.36, p=0.174; MIDAS: χ²=6.54, p=0.162). <h3>Conclusion and Relevance</h3> In this real-world migraine cohort of patients, preventive therapies targeting the CGRP pathway led to sustained clinical improvements, with ~55–70% of patients achieving MCID in HIT-6 and MIDAS at all follow-up points up to 24 months. These findings support the effectiveness and durability of anti-CGRP therapies in routine clinical practice and underline the value of PROM-based longitudinal monitoring through telepharmacy platforms. <h3>Conflict of Interest</h3> No conflict of interest