Real world treatment patterns and unmet needs of migraine preventive treatments in Japan: JMDC claims analysis
Abstract
OBJECTIVE: We evaluated real-world treatment patterns and unmet needs associated with migraine preventive medications in Japan following the introduction of calcitonin gene-related peptide monoclonal antibodies (CGRP mAbs), focusing on persistence, switching, and adherence rates.
METHODS: This retrospective cohort study analyzed JMDC (previously Japan Medical Data Center) claims data (index date: April 2021 to January 2024) for treatment-naïve patients who initiated oral migraine preventive medications (OMPMs; n = 12,750) and patients initiating CGRP mAbs (n = 3,280). Persistence was defined as continuous therapy without a 60-day or longer gap. Treatment patterns were evaluated at 3, 6, and 12 months post-initiation.
RESULTS: Most patients were female (74.1% OMPMs, 78.1% CGRP mAbs), over half of childbearing age. For OMPM initiators, persistence rates declined from 49.7% at 3 months to 21.7% at 12 months, with antiepileptics showing highest persistence (27.0%). CGRP mAb initiators demonstrated higher initial persistence (85.6% at 3 months), declining to 36.5% at 12 months. 22.9% of OMPM and 19.7% of CGRP mAb patients switched by 12 months. Among OMPM switchers, only 20% switched to CGRP mAbs. Both cohorts had a high prevalence of comorbidities, including non-migraine headaches (approx. 50%), mental health disorders (26-31%), and sleep disorders (approx. 29%).
CONCLUSION: Substantial unmet needs exist in migraine preventive treatment in Japan, as demonstrated by low 12-month…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 16,000 participants or records.
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