Patterns of calcitonin gene-related peptide monoclonal antibody use in people with migraine: Results of the OVERCOME (US) study
Abstract
Background Understanding characteristics and reasons associated with using calcitonin gene-related peptide monoclonal antibodies (CGRP mAb) for migraine prevention may help clinicians individualize treatment plans and achieve better patient outcomes. Methods We analyzed 2019–2020 cohort data of OVERCOME (US), a population-based survey among adults with migraine. Eligible participants were categorized based on current CGRP mAb usage (“NEVER” and “EVER” users [“Continued”, “Switched” and “Discontinued”]). Machine learning techniques followed by logistic regression were used to examine, among 60 sociodemographic, clinical, migraine-related- and migraine treatment utilization characteristics, those associated with CGRP mAb use status. Results Of 39,113 participants, 25.6% had ever used migraine preventive medication(s) and 5.0% used CGRP mAbs (of which 46.1% Continued, 14.7% Switched and 39.3% Discontinued). Top factors associated with higher odds of CGRP mAb EVER vs. NEVER use were currently using recommended acute medication (odds ratio (OR) = 2.43; 95% confidence interval (CI) = 2.09–2.82) and contraindications for triptan use (OR = 2.32; 95% CI = 2.06–2.60). Continuing use vs. switching or discontinuing was most associated with current use of botulinum toxin for migraine (OR = 2.21; 95% CI = 1.42–3.44 and OR = 4.53; 95% CI = 3.14–6.55, respectively). Conclusions At the time of survey, CGRP-targeted mAbs remain underutilized for migraine and multiple characteristics are…
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