Eli Lilly and Company, Indianapolis, IN, USA.
Adelphi Real World, Adelphi Mill, Bollington, UK.
Headache. 2017 Nov;57(10):1532-1544. doi: 10.1111/head.13202. Epub 2017 Oct 6.
The purpose of this cross-sectional study was to assess the sociodemographics, disease burden, and treatment patterns of patients with episodic and chronic migraine in the United States.
Migraine is a disabling neurological disease that places an enormous burden on patients.
Data were drawn from the Adelphi Migraine United States Disease Specific Programme (index period: January to March 2014). Physicians (N = 150) completed a patient report form on 10 consulting patients with migraine. Episodic migraineurs had ≤14 headache days per month (HDM) and those with chronic migraine had ≥15. Headache-related disability was assessed with the Migraine Disability Assessment (MIDAS) questionnaire. Disability was also compared across subgroups based on the number of HDM (≤3, 4-7, 8-14, and ≥15).
A total of 1487 patient report forms were completed. Over 70% of the patients were female, 90.8% (n = 1350) were episodic migraineurs, and 9.2% (n = 137) were chronic migraineurs. Acute treatment was prescribed for >90% of the patients, and >50% had a current prescription for preventive treatment. Despite taking acute and/or preventive treatment, 29.2% of episodic migraineurs (including some patients with ≤3 headache days/month) and 73.2% of chronic migraineurs had moderate-to-severe headache-related disability (MIDAS total score ≥11). Preventive treatment was discontinued/switched at least once by 26.4% of episodic migraineurs and by 53.3% of chronic migraineurs. Of those patients (n = 382) who gave collective reasons for discontinuation/switching preventive treatment, over 70% selected lack of efficacy and tolerability/safety.
This real-world analysis provides additional support for the unmet medical need for efficacious therapies that reduce migraine frequency and severity, headache-related disability, and have better tolerability for patients with migraine. In addition, further research is needed to better understand the burden of illness among patients with lower migraine frequency, and to implement treatment strategies to prevent progression of the disease.
本横断面研究旨在评估美国发作性和慢性偏头痛患者的人口统计学特征、疾病负担和治疗模式。
偏头痛是一种使人丧失能力的神经系统疾病，给患者带来了巨大的负担。
数据来自 Adelphi 偏头痛美国特定疾病计划（索引期：2014 年 1 月至 3 月）。医生（n=150）对 10 名偏头痛就诊患者填写了患者报告表。发作性偏头痛患者每月头痛日数（HDM）≤14 天，慢性偏头痛患者每月头痛日数≥15 天。偏头痛残疾评估（MIDAS）问卷评估头痛相关残疾。还根据每月头痛日数（≤3、4-7、8-14 和≥15）将残疾与亚组进行比较。
共完成了 1487 份患者报告表。超过 70%的患者为女性，90.8%（n=1350）为发作性偏头痛患者，9.2%（n=137）为慢性偏头痛患者。超过 90%的患者开具了急性治疗药物，超过 50%的患者正在服用预防性治疗药物。尽管使用了急性和/或预防性治疗药物，29.2%的发作性偏头痛患者（包括一些每月头痛日数≤3 的患者）和 73.2%的慢性偏头痛患者仍存在中重度头痛相关残疾（MIDAS 总分≥11）。26.4%的发作性偏头痛患者和 53.3%的慢性偏头痛患者至少停用/更换过一次预防性治疗药物。在那些（n=382）因停用/更换预防性治疗药物而给出综合原因的患者中，超过 70%的患者选择了疗效不佳和不耐受/安全性差。
这项真实世界的分析为需要有效治疗药物提供了更多支持，这些药物可降低偏头痛发作频率和严重程度、头痛相关残疾，并且具有更好的耐受性。此外，还需要进一步研究来更好地了解低偏头痛频率患者的疾病负担，并实施预防疾病进展的治疗策略。
