Patient-Reported Outcomes Similarly Impacted By Migraine Treatments

Researchers recently found that patient-reported outcomes (PROs) were no different among patients treated with calcitonin gene-related peptide (CGRP) antagonists or onabotulinumtoxinA (ONA) for the indication of chronic migraine prophylaxis. 

“[CGRP] antagonists are a new drug class indicated for chronic migraine prevention,” explained lead study author Patricia Taddei-Allen, PharmD, and colleagues. “With the release and availability of CGRPs, there is little real-world evidence that compares [PROs] of CGRP antagonists and onabotulinumtoxinA in patients with chronic migraine.” 

To compare PROs between patients on CGRP antagonists vs ONA for chronic migraine, Dr Taddei-Allen and her colleagues created a customized electronic questionnaire for migraine-related outcomes. The questionnaire was implemented into the specialty pharmacy workflow. The research team identified patients who were on a CGRP antagonist or on ONA for the indication of chronic migraine prophylaxis from January 1, 2018 through December 1, 2018.  

“Pharmacists telephonically reached out to patients to assess number of migraine headache days (MHD), average pain severity of migraines on a scale of 1 to 10, average duration of migraines in hours; a HIT-6 questionnaire was also conducted,” Dr Taddei-Allen and colleagues explained. “Responders were identified if they had at least a 50% reduction in baseline MHD during the study period, and proportions were compared using chi-square. Patients were also identified if they had at least a one severity class improvement per the HIT-6, and proportions were compared between the groups using chi-square.” 

The researchers identified 42 patients, with 21 in the ONA and CGRP groups. According to the findings of the study, at baseline, the ONA group was 90% female, with an average age of 47 years, 20 MHD, pain severity 9, and 45 hours duration per migraine, and the CGRP group was 71% female with an average age of 47 years, 16 MHD, pain severity of 7, and 23 hours duration. The researchers said that there was no difference in the proportion of patients who experienced at least 50% reduction from baseline in MHD between the groups or among patients who experienced at least one class decrease in severity per the HIT-6. Further, both study groups experienced differences from baseline in MHD and pain severity, but only the ONA group experienced a larger decrease in duration of migraine.

“There was no difference between CGRP and ONA groups using PROs with at least a 50% reduction from baseline in MHD or HIT-6 class severity improvement,” Dr Taddei-Allen and colleagues concluded. “Patients in both groups experienced significant improvement in MHD and pain, but only the ONA group experienced decrease in migraine duration.” —Julie Gould