Table 1 Baseline characteristics of 69,589 patients who initiated topiramate or anti-CGRP treatment for migraine prevention between May 17th 2018 and February 28th 2023

Age, mean (SD), y

43.4 (10.5)

40.7 (10.6)

54.4 (11.2)

53.6 (11.8)

Gender ^a, women (%)

5,507 (51.2)

12,907 (40.1)

2,623 (32.3)

4,394 (23.8)

Race ^a (%)

 White

7,214 (67.1)

18,403 (57.1)

5,209 (64.1)

10,122 (54.8)

 Black

2,218 (20.6)

9,327 (28.9)

2,206 (27.2)

6,524 (35.3)

 Asian

147 (1.4)

690 (2.1)

90 (1.1)

278 (1.5)

 Others/Unknown ^b

1,180 (11.0)

3,804 (11.8)

616 (7.6)

1,561 (8.4)

Ethnicity ^a, non-Hispanics (%)

9,576 (89.0)

28,026 (87.0)

7,485 (92.2)

17,013 (92.0)

Service connection, yes (%)

10,370 (96.4)

30,641 (95.1)

7,530 (92.7)

16,600 (89.8)

Rurality (%)

 Urban

7,616 (70.8)

23,796 (73.8)

5,579 (68.7)

12,676 (68.6)

 Rural

3,122 (29.0)

8,320 (25.8)

2,537 (31.2)

5,769 (31.2)

 Unknown

21 (0.2)

108 (0.3)

5 (0.1)

40 (0.2)

Smoking status (%)

 Never

5,711 (53.1)

16,125 (50.0)

3,976 (49.0)

8,045 (43.5)

 Current

3,083 (28.7)

10,097 (31.3)

2,370 (29.2)

6,528 (35.3)

 Former

1,921 (17.9)

5,630 (17.5)

1,770 (21.8)

3,885 (21.0)

 Unknown

44 (0.4)

372 (1.2)

5 (0.1)

27 (0.1)

BMI, mean (SD), kg/m²

30.2 (5.8)

30.7 (5.8)

32.5 (6.2)

33.0 (6.4)

 Underweight/Normal

1,912 (17.8)

4,797 (14.9)

752 (9.3)

1,511 (8.2)

 Overweight

3,650 (33.9)

10,712 (33.2)

2,208 (27.2)

4,897 (26.5)

 Obese

5,054 (47.0)

16,096 (50.0)

5,145 (63.4)

12,013 (65.0)

 Unknown

143 (1.3)

619 (1.9)

16 (0.2)

64 (0.3)

Systolic BP, mean (SD), mm Hg

121.8 (12.8)

122.6 (12.8)

130.1 (15.4)

131.7 (15.6)

Diastolic BP, mean (SD), mm Hg

77.5 (8.9)

77.3 (9.0)

80.3 (9.7)

80.8 (10.1)

Years since onset of migraine, mean (SD)

5.0 (4.2)

1.9 (3.1)

6.4 (4.5)

3.0 (4.0)

Chronic migraine (%)

5,507 (51.2)

5,170 (16.0)

4,545 (56.0)

3,250 (17.6)

Headache-related encounters in the past year

 Primary care, mean (SD)

1.2 (1.3)

0.9 (1.0)

1.2 (1.5)

0.8 (1.0)

 Emergency room, mean (SD)

0.2 (0.9)

0.1 (0.4)

0.2 (1.1)

0.1 (0.5)

 Neurology, mean (SD)

2.3 (2.3)

0.4 (0.9)

2.4 (2.4)

0.5 (1.0)

Prescribed Triptans (%)

8,638 (80.3)

14,624 (45.4)

5,860 (72.2)

7,591 (41.1)

History of migraine preventives, ever

 No. of medications, mean (SD)

2.1 (1.4)

0.5 (0.8)

2.8 (1.6)

1.1 (1.2)

 Other Anticonvulsants ^c (%)

4,870 (45.3)

3,292 (10.2)

4,392 (54.1)

3,042 (16.5)

 ACEI/ARB (%) ^d

262 (2.4)

324 (1.0)

3,099 (38.2)

4,540 (24.6)

 β-blockers (%) ^d

5,034 (46.8)

4,522 (14.0)

5,201 (64.0)

5,844 (31.6)

 TCAs (%)

4,625 (43.0)

4,355 (13.5)

3,742 (46.1)

3,023 (16.4)

 Neurotoxins (%)

4,485 (41.7)

761 (2.4)

3,554 (43.8)

495 (2.7)

Alcohol-related disorder (%)

1,790 (16.6)

5,575 (17.3)

1,868 (23.0)

4,706 (25.5)

Chronic kidney disease (%)

188 (1.7)

277 (0.9)

798 (9.8)

1,506 (8.1)

Diabetes (%)

594 (5.5)

1,386 (4.3)

2,677 (33.0)

5,854 (31.7)

Hyperlipidemia (%)

3,856 (35.8)

8,606 (26.7)

5,926 (73.0)

12,608 (68.2)

Obstructive sleep apnea (%)

3,532 (32.8)

7,491 (23.2)

4,751 (58.5)

8,788 (47.5)

Medications with antihypertensive effect

 No. of medications, mean (SD)

1.5 (1.3)

1.4 (1.3)

 ACEIs/ARBs (%) ^d

3,062 (37.7)

7,334 (39.7)

 α-blockers (%)

1,232 (15.2)

2,464 (13.3)

 β-blockers (%) ^d

3,094 (38.1)

5,223 (28.3)

 Calcium channel blockers (%)

2,198 (27.1)

4,666 (25.2)

 Centrally acting sympathetic agonist (%)

181 (2.2)

324 (1.8)

 Diuretics, potassium-sparing (%)

398 (4.9)

752 (4.1)

 Diuretics, thiazide (%)

1,634 (20.1)

4,135 (22.4)

 Diuretics, loop (%)

382 (4.7)

776 (4.2)

 Nitrates (%)

171 (2.1)

401 (2.2)

 Direct renin blocker (%)

0 (0.0)

2 (< 0.1)

 Vasodilators (%)

134 (1.7)

262 (1.4)

Follow-up, Median (IQR), y

1.1 (0.4–2.2)

0.8 (0.2–1.8)

1.0 (0.4–2.2)

0.9 (0.2–2.1)

Medication possession ratio, Median (IQR)

0.89 (0.64–1.00)

0.83 (0.53–1.00)

0.92 (0.68–1.00)

0.89 (0.59–1.00)

No. of BP measurements, Median (IQR)

5.0 (3.0–11.0)

4.0 (2.0–8.0)

7.0 (4.0–15.0)

6.0 (3.0–12.0)