Title: Changes in Acute Migraine-specific Medications After Initiating Erenumab: Results from a Real-world Retrospective Cohort Study in the United States (1685)
Abstract: Objective: To examine real-world changes in acute migraine-specific medication (AMSMs) use among patients prescribed erenumab in the United States (US). Background: Overuse of AMSMs can potentially complicate rather than support migraine management. Erenumab is a calcitonin gene-related peptide (CGRP) antagonist indicated for the preventive treatment of migraine in adults that has been shown to significantly reduce use of AMSMs. Design/Methods: We conducted a retrospective cohort study using data from IQVIA’s open source pharmacy (LRx) and medical claims (Dx) databases. Patients 18 years or older were included if they had completed an adequate trial of erenumab (≥3 claims) between 5/1/18–4/30/19 (first claim was index date) with data continuity in the 12 months prior to and ≥6 months following the index date. Post-index change in AMSMs use (triptans and ergotamine derivatives used both pre-and-post index) included discontinuation (no refills for ≥60 days after last post-index fill) and change (post-pre index) in units (tablets/pills) filled. Results: We identified 43,185 patients who received ≥3 doses of erenumab; female (85.8%), average (SD) age 47 (12.9) years. After initiation of Erenumab, AMSMs were discontinued in 8,556 of 23,222 patients with both pre- and post-index use (36.8%); triptans 8,021 of 22,338 patients (35.9%) and ergotamines 535 of 884 patients (60.5%). AMSM units changed in 18,571 of 23,222 patients (80.0%); triptans 18,034 of 22,338 patients (80.7%) and ergotamines 537 of 884 patients (60.7%) with an overall mean (SD) change of −1.2 (6.6) units for triptans and −0.4 (6.9) units for ergotamines. Conclusions: In this US focused real-world study, a proportion of patients completing an adequate trial of erenumab discontinued and/or reduced consumption of their AMSMs. There is evidence that the benefits of erenumab seen in clinical trials, in terms of reductions in acute migraine-specific medications are being realized in real-world clinical practice. Disclosure: Dr. Hines has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with IQVIA. Dr. Shah has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Amgen. Dr. Multani has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with IQVIA. Dr. Wade has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with IQVIA. Dr. Buse has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Dawn C. Buse, PhD, has received grant support and honoraria from Allergan, Avanir, Amgen, Biohaven, Eli Lilly and Company, and Promius and for work on the editorial board of Current Pain and Headache Reports.. Dr. Buse has received personal compensation in an editorial capacity for Dawn C. Buse, PhD, has received grant support and honoraria from Allergan, Avanir, Amgen, Biohaven, Eli Lilly and Company, and Promius and for work on the editorial board of Current Pain and Headache Reports.. Dr. Buse has received research support from Dawn C. Buse, PhD, has received grant support and honoraria from Allergan, Avanir, Amgen, Biohaven, Eli Lilly and Company, and Promius and for work on the editorial board of Current Pain and Headache Reports.. Dr. Bensink has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Amgen. Dr. Bensink holds stock and/or stock options in Amgen which sponsored research in which Dr. Bensink was involved as an investigator.
Publication Year: 2020
Publication Date: 2020-04-14
Language: en
Type: article
Indexed In: ['crossref']
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Cited By Count: 3
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