Multani Jasjit K, Urman Robert, Park Andrew S, Gill Karminder, Vuvu Fiston, Sun Kainan, Patel Leah B, Stockl Karen M, Hawkins Kevin, Rhyne Christopher, Bensink Mark E
IQVIA, Falls Church, Virginia, USA.
Amgen Inc., Thousand Oaks, California, USA.
Headache. 2025 Jan;65(1):68-79. doi: 10.1111/head.14820. Epub 2024 Sep 9.
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.
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.
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.
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.
In this long-term study, we observed the discontinuation of both acute and preventive medications for migraine post-erenumab initiation.
评估在美国启动抗降钙素基因相关肽（CGRP）通路单克隆抗体（mAb）erenumab后的12个月随访期内，偏头痛急性和预防性药物的实际使用变化。
启动erenumab后，对偏头痛急性和预防性药物实际使用的早期评估仅限于6个月的随访。
这项回顾性队列研究使用了IQVIA开源纵向处方（LRx）和医疗（Dx）索赔数据库的数据。确定了2018年5月至2020年4月期间首次开具erenumab处方（索引日期）的成年患者。
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）为女性。大多数患者在索引前12个月期间使用了一种或多种急性药物（88.4%；n = 177,795）和一种或多种传统预防性药物（86.1%；n = 173,225）。erenumab的依从性（覆盖天数比例[PDC]≥0.80）为40.2%（n = 80,927），总体平均（SD）PDC为0.60（0.34）。在所有患者中，70.0%（n = 140,809）停用了erenumab。在考虑重新启动erenumab的24.7%（n = 49,720）患者后，45.3%（n = 91,089）的总患者出现了未重新启动的停药情况。13.1%（n = 26,446）的总患者改用了另一种抗CGRP通路mAb。在177,795名索引前使用一种或多种急性偏头痛药物类别的患者中，86.5%（n = 153,788）在索引后使用了同一类药物，其中56.7%（87,134/153,788）在12个月随访期内停用了一种或多种急性药物类别。同样，在173,225名索引前使用一种或多种传统偏头痛预防性药物类别的患者中，67.7%（n = 117,274）在索引后使用了同一类药物，其中46.7%（54,790/117,274）在12个月随访期内停用了一种或多种传统预防性药物类别。
在这项长期研究中，我们观察到启动erenumab后偏头痛急性和预防性药物均出现停药情况。
