Changes in use of acute and preventive medications for migraine after erenumab initiation over 12 months: A United States retrospective cohort study.

IF 5.4 2区医学 Q1 CLINICAL NEUROLOGY

Headache Pub Date : 2024-09-09 DOI:10.1111/head.14820

Jasjit K Multani, Robert Urman, Andrew S Park, Karminder Gill, Fiston Vuvu, Kainan Sun, Leah B Patel, Karen M Stockl, Kevin Hawkins, Christopher Rhyne, Mark E Bensink

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引用次数: 0

Abstract

Objective: To assess changes in real-world use of acute and preventive medications for migraine over a 12-month follow-up period in the United States following initiation of the anti-calcitonin gene-related peptide (CGRP) pathway monoclonal antibody (mAb) erenumab.

Background: Early assessments of real-world use of acute and preventive medications for migraine after initiation of erenumab have been limited to 6 months of follow-up.

Methods: This retrospective cohort study used data from the IQVIA open-source longitudinal prescription (LRx) and medical (Dx) claims databases. Adult patients with an initial claim (index date) for erenumab between May 2018 and April 2020 were identified.

Results: Among 201,176 patients who met inclusion criteria, the mean (standard deviation [SD]) age was 47.5 (13.8) years and 85.6% (n = 172,153) were female. Most patients used one or more acute (88.4%; n = 177,795) and one or more traditional preventive (86.1%; n = 173,225) medications during the 12-month pre-index period. Adherence to erenumab (proportion of days covered [PDC] ≥0.80) was 40.2% (n = 80,927) with an overall mean (SD) PDC of 0.60 (0.34). Among all patients, 70.0% (n = 140,809) discontinued erenumab. After accounting for 24.7% (n = 49,720) of patients who restarted erenumab, discontinuation without reinitiation was observed in 45.3% (n = 91,089) of total patients. Switching to a different anti-CGRP pathway mAb was observed in 13.1% (n = 26,446) of total patients. Among 177,795 patients with pre-index use of one or more acute migraine medication class, 86.5% (n = 153,788) had post-index use of the same class, and 56.7% (87,134/153,788) of them discontinued one or more class of acute medication in the 12-month follow-up period. Similarly, among 173,225 patients with pre-index use of one or more traditional migraine preventive medication class, 67.7% (n = 117,274) had post-index use of the same class, and 46.7% (54,790/117,274) of them discontinued one or more class of traditional preventive medication in the 12-month follow-up period.

Conclusions: In this long-term study, we observed the discontinuation of both acute and preventive medications for migraine post-erenumab initiation.

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开始使用艾伦单抗 12 个月后偏头痛急性和预防性药物使用的变化：一项美国回顾性队列研究。

目的：目的：评估在美国开始使用抗降钙素基因相关肽（CGRP）通路单克隆抗体（mAb）艾伦单抗后的12个月随访期内，偏头痛急性期和预防性药物实际使用情况的变化：背景：对开始使用艾伦单抗后偏头痛急性和预防性药物实际使用情况的早期评估仅限于6个月的随访：这项回顾性队列研究使用的数据来自IQVIA开源纵向处方（LRx）和医疗（Dx）索赔数据库。确定了 2018 年 5 月至 2020 年 4 月期间首次报销（索引日期）艾伦单抗的成人患者：在符合纳入标准的 201,176 名患者中，平均（标准差 [SD]）年龄为 47.5 (13.8)岁，85.6%（n = 172,153 人）为女性。大多数患者在指数发布前的 12 个月内使用过一种或多种急性药物（88.4%；n = 177,795 例）和一种或多种传统预防药物（86.1%；n = 173,225 例）。依仑单抗的依从性（覆盖天数比例 [PDC] ≥0.80）为 40.2%（n = 80,927），总体平均（标清）PDC 为 0.60 (0.34)。在所有患者中，70.0%（n = 140,809）的患者停用了艾伦单抗。在重新开始使用艾伦单抗的患者中，有24.7%（n = 49,720）的患者停用了艾伦单抗，在所有患者中，有45.3%（n = 91,089）的患者没有重新开始使用艾伦单抗。在所有患者中，13.1%（n = 26446）的患者转用了不同的抗 CGRP 通路 mAb。在177,795名索引前使用过一种或多种急性偏头痛药物的患者中，86.5%（n = 153,788）在索引后使用过同类药物，其中56.7%（87,134/153,788）的患者在12个月的随访期间停用了一种或多种急性药物。同样，在173,225名指数前使用过一种或多种传统偏头痛预防药物的患者中，67.7%（n = 117,274）在指数后使用过同一类药物，其中46.7%（54,790/117,274）在12个月的随访期间停用了一种或多种传统预防药物：在这项长期研究中，我们观察到在开始使用艾伦单抗治疗偏头痛后，急性和预防性药物均有停用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Headache 医学-临床神经学

CiteScore

9.40

自引率

10.00%

发文量

172

审稿时长

3-8 weeks

期刊介绍： Headache publishes original articles on all aspects of head and face pain including communications on clinical and basic research, diagnosis and management, epidemiology, genetics, and pathophysiology of primary and secondary headaches, cranial neuralgias, and pains referred to the head and face. Monthly issues feature case reports, short communications, review articles, letters to the editor, and news items regarding AHS plus medicolegal and socioeconomic aspects of head pain. This is the official journal of the American Headache Society.