Patient satisfaction with calcitonin gene-related peptide monoclonal antibodies in migraine: A multicenter prospective cohort study.

Abstract

Background: Calcitonin gene-related peptide monoclonal antibodies (CGRP mAbs) are the first migraine-specific prophylactic medication. Clinical data regarding patient treatment satisfaction (TS) with CGRP mAbs are limited.

Methods: A multicenter prospective cohort study was conducted in patients with ≥8 headache days/month who started treatment with erenumab, galcanezumab, or fremanezumab. Monthly migraine days (MMD), monthly headache days (MHD), Migraine Disability Assessment (MIDAS), and the six-item Headache Impact Test (HIT-6) scores were collected. Patients' satisfaction with treatment (effectiveness, convenience, side effects, and global satisfaction) was assessed by the Treatment Satisfaction Questionnaire for Medication, version 1.4 (TSQM-1.4©).

Results: A total of 400 patients were included. The median (interquartile range [IQR]) TS scores were high (≥70%) across all domains of the TSQM-1.4 after 3 and 6 months of CGRP mAb therapy: 72.2 (50.0-83.3) and 83.3 (61.1-88.9) for effectiveness, 83.3 (72.2-100) and 83.3 (77.8-100) for convenience, and finally, a score of 78.6 (50.0-92.9) and 85.7 (71.4-92.9) for global satisfaction. The median (IQR) reduction in MHD and MMD was 10.0 (3.0-17.0; p < 0.001) and 8.0 (4.0-12.0; p < 0.001) days after 3 months of treatment, and 10.0 (3.0-17.0; p < 0.001) and 9.0 (5.0-17.0; p < 0.001) days after 6 months. The median (IQR) HIT-6 score decreased from 68.0 (65.0-72.0) to 60.0 (51.0-66.0; p < 0.001) at Month 3 and to 56.0 (48.0-64.0; p < 0.001) at Month 6. Finally, the median (IQR) MIDAS score decreased from 70 (40.0-120.0) to 24 (7.8-60.0; p < 0.001) and 17 (5.0-45.0; p < 0.001) at Months 3 and 6, respectively. The median change from baseline in MMD was significantly associated with effectiveness at 3 (β = -0.93, 95% CI -1.34 to -0.53; p < 0.001) and 6 months (β = -1.56, 95% CI -2.15 to -0.97; p < 0.001). Similarly, reductions in MMD were significantly associated with the global satisfaction dimension of the questionnaire (β = -0.82, 95% CI -1.27 to -0.37; p < 0.001) and (β = -1.80, 95% CI -2.42 to -1.18; p < 0.001).

Conclusions: Most patients were satisfied with CGRP mAbs' effectiveness, tolerability, and convenience in a real-world setting. Interestingly, increasing TS was associated with meaningful reductions in frequency, impact, and disability caused by migraine.