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Background and Importance Migraine is one of the leading causes of disability in working-age adults, ranking second globally and first among young women, with a significant impact on quality of life and productivity. 1 Monoclonal antibodies targeting CGRP or its receptor (anti-CGRP mAbs) have shown efficacy and safety as preventive options and are now recommended as first-line therapies.2 Real-world data confirm sustained reductions in migraine days with treatment.3 Aim and Objectives To evaluate the efficacy and safety of chronic migraine patients treated with anti-CGRP mAbs in clinical practice at a central hospital.Material and Methods A retrospective observational study including patients who initiated anti-CGRP mAbs between January 2019 and May 2025. Demographic and clinical data were collected: age, gender, treatment duration (TT), migraine days per month (MDM), and adverse events (AE). Descriptive statistics summarised the cohort. Efficacy was evaluated by the change in MDM from baseline to 6 months (Δ = baseline–6M) and by responder rate (≥50% reduction). Paired t-tests or Wilcoxon tests were used according to data distribution. Safety was analysed by AE incidence. Data were extracted from electronic health records and analysed using Microsoft Excel for Microsoft 365 with Analysis ToolPak and Real Statistics add-ins.Results Ninety-two patients were included (Galcanezumab 56; Erenumab 23; Fremanezumab 13); 90.0% were women, mean age 45.1 years, and mean TT 12.6 months. AEs were reported by 18.5% (17/92): mainly injection site reactions (galcanezumab and fremanezumab) and constipation (erenumab). In the subset with 6-month paired data (n=48: Galcanezumab 29; Erenumab 11; Fremanezumab 8), 89.6% were women, mean age 46.6 years and mean TT 20.0 months (erenumab), 12.9 months (fremanezumab) and 19.0 months (galcanezumab). Mean MDM reduction was: galcanezumab –7.3 days/month (p<0.0001), erenumab –5.9 (p=0.001), and fremanezumab –3.5 (p=0.0078). Responder rates (≥50% reduction) were 82.8%, 90.9%, and 63.0%, respectively.Conclusion and Relevance In real-world clinical practice, anti-CGRP mAbs were associated with significant reductions in migraine frequency after 6 months. Galcanezumab showed the greatest mean reduction, while response rates were particularly high for galcanezumab and erenumab. The safety profile was favourable, consistent with literature data [3] and current recommendations supporting these agents as first-line preventive therapies [2]. Further prospective studies with larger cohorts are warranted.References and/or Acknowledgements 1. J Headache Pain 2020 Dec 2; 21(1).2. Headache 2024 Apr;64(4).3. Cephalalgia 2025 Aug;45(8).Conflict of Interest No conflict of interest