Assessment tools and outcomes in real–world migraine patients eligible for treatment with an anti–calcitonin gene–related peptide antibody

Abstract

Real–world clinical outcomes were examined in 96 patients with migraine who were eligible for treatment with anti–calcitonin gene–related peptide (CGRP) antibodies. In 71 patients who received this treatment, three assessment tools (Migraine Disability Assessment Scale (MIDAS), Headache Impact Test (HIT–6), and Visual Analog Scale (VAS)) were used to evaluate the efficacy of the drugs. The 25 patients who declined to take anti–CGRP antibody drugs were asked about the reasons for their refusal and issues about use of these drugs. Patients with episodic migraine (EM) or chronic migraine (CM) had significantly decreased monthly migraine days (MMD) and improved daily disability after treatment with Galcanezumab or Fremanezumab. The two drugs were rated as very effective migraine prophylactics. The 50% responder rate (50%RR) for patients with CM who received Galcanezumab in the first month was significantly lower than that for patients with EM, Galcanezumab was less responsive to treatment for patients with CM. This is also the first study to evaluate the degree of daily life disability using three assessment tools concurrently. The results showed that HIT–6 and VAS, which are one–month indicators, were more sensitive than MIDAS, which is a three–month indicator. The main concerns among patients for introduction of anti–CGRP antibody drugs were the high cost and the increased frequency of hospital visits. Therefore, reduction of costs and fewer visits are needed to promote use of anti–CGRP antibody drugs with high efficacy.