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Table 4 Discontinuation of traditional acute and preventive migraine medications during the 6-month post-index period, overall and by prior mAb use

From: Treatment patterns for patients initiating novel acute migraine specific medications (nAMSMs) in the context of monoclonal antibodies (mAbs) targeting the calcitonin gene-related peptide (CGRP) pathway

 

Overall

N = 78,574

Patients with prior mAb usea

N = 26,656

Patients without prior mAb usea

N = 51,918

Discontinuation of acute migraine treatmentsb

Pre-index acute migraine treatment use, n (%)

59,290 (75.5)

21,842 (81.9)

37,448 (72.1)

Patients with ≥ 1 claim for acute migraine medication pre- and post-index, n (%)

42,338 (71.4)

16,826 (77.0)

25,512 (68.1)

 Patients with discontinuation of any acute migraine medication class, n (%)c

15,953 (37.7)

6,157 (36.6)

9,796 (38.4)

Pre-index triptan use, n (%)

36,054 (45.9)

14,182 (53.2)

21,872 (42.1)

Patients with ≥ 1 claim for triptan pre- and post-index, n (%)

20,677 (57.4)

9,081 (64.0)

11,596 (53.0)

 Patients with triptan discontinuation, n (%)c

6,665 (32.2)

2,686 (29.6)

3,979 (34.3)

Pre-index opioid use, n (%)

29,692 (37.8)

11,116 (41.7)

18,576 (35.8)

Patients with ≥ 1 claim for opioid pre- and post-index, n (%)

20,745 (69.9)

8,121 (73.1)

12,624 (68.0)

 Patients with opioid discontinuation, n (%)c

4,610 (22.2)

1,687 (20.8)

2,923 (23.2)

Pre-index ergot use, n (%)

1,255 (1.6)

718 (2.7)

537 (1.0)

Patients with ≥ 1 claim for ergot pre- and post-index, n (%)

501 (39.9)

300 (41.8)

201 (37.4)

 Patients with ergot discontinuation, n (%)c

223 (44.5)

138 (46.0)

85 (42.3)

Pre-index NSAID use, n (%)

26,644 (33.9)

10,118 (38.0)

16,526 (31.8)

Patients with ≥ 1 claim for NSAID pre- and post-index, n (%)

16,101 (60.4)

6,518 (64.4)

9,583 (58.0)

 Patients with NSAID discontinuation, n (%)c

6,253 (38.8)

2,396 (36.8)

3,857 (40.3)

Discontinuation of concomitant preventive migraine medicationsd,e

Pre-index preventive migraine medication use, n (%)

62,428 (79.5)

22,378 (84.0)

40,050 (77.1)

Patients with concomitant use of ≥ 1 preventive migraine medication, n (%)

55,166 (88.4)

19,671 (87.9)

35,495 (88.6)

 Patients with discontinuation of any concomitant preventive medication, n (% of patients with concomitant use)

16,593 (30.1)

5,368 (27.3)

11,225 (31.6)

Pre-index anticonvulsant use, n (%)

34,930 (44.5)

13,197 (49.5)

21,733 (41.9)

Patients with concomitant use of select anticonvulsant medicationsf, n (%)

27,058 (77.5)

10,028 (76.0)

17,030 (78.4)

 Patients with discontinuation of concomitant select anticonvulsant medications, n (% of patients with concomitant use)

6,205 (22.9)

1,872 (18.7)

4,333 (25.4)

Pre-index antihypertensive use, n (%)

24,751 (31.5)

9,243 (34.7)

15,508 (29.9)

Patients with concomitant use of select antihypertensive medicationsg, n (%)

19,788 (79.9)

7,277 (78.7)

12,511 (80.7)

 Patients with discontinuation of concomitant select antihypertensive medications, n (% of patients with concomitant use)

3,794 (19.2)

1,208 (16.6)

2,586 (20.7)

Pre-index antidepressant use, n (%)

37,753 (48.1)

14,108 (52.9)

23,645 (45.5)

Patients with concomitant use of select antidepressant medicationsh, n (%)

30,283 (80.2)

11,307 (80.1)

18,976 (80.3)

 Patients with discontinuation of concomitant select antidepressant medications, n (% of patients with concomitant use)

5,324 (17.6)

1,670 (14.8)

3,654 (19.3)

Pre-index botulinum toxin use, n (%)

9,669 (12.3)

3,378 (12.7)

6,291 (12.1)

Patients with concomitant use of select botulinum toxin medicationsi, n (%)

8,033 (83.1)

2,682 (79.4)

5,351 (85.13)

 Patients with discontinuation of concomitant select botulinum toxin medications, n (% of patients with concomitant use)

1,252 (15.6)

397 (14.8)

855 (16.0)

Pre-index other medication that prevent migraine use, n (%)

12,494 (15.9)

5,353 (20.1)

7,141 (13.8)

Patients with concomitant use of other medications that prevent migrainesj, n (%)

7,680 (61.5)

3,382 (63.2)

4,298 (60.2)

 Patients with discontinuation of concomitant other medications that prevent migraines, n (% of patients with concomitant use)

2,354 (30.7)

969 (28.7)

1,385 (32.2)

  1. mAb monoclonal antibody, NSAIDs non-steroidal anti-inflammatory drugs
  2. aPrior mAb (erenumab, galcanezumab, fremanezumab) use was evaluated during the 6-month period prior to the index date
  3. bDiscontinuation of acute migraine medication was defined as no claims for the same therapeutic class of acute treatment during the 60 days prior to the end of the post-index period
  4. cAmongst patients with ≥ 1 claim pre- and post-index
  5. dConcomitant preventive anti-migraine therapy with novel acute migraine specific medication (nAMSM) was defined as a claim for ≥ 1 preventive medication class in the pre-index period with days supply that overlaps with the index date
  6. eDiscontinuation of concomitant preventive treatment was defined as a ≥ 60-day gap (≥ 90 days for botulinum toxins which are administered every 3 months) in preventive medication (after the end of days supply) in the post-index period
  7. fSelect anticonvulsant medications included oral formulations of carbamazepine, gabapentin, levetiracetam, pregabalin, topiramate, valproate sodium, valproic acid, divalproex sodium, and zonisamide
  8. gSelect antihypertensive medications included oral formulations (unless noted otherwise) of atenolol, bisoprolol, metoprolol, nadolol, nebivolol, pindolol, propranolol, timolol, verapamil, candesartan, clonidine (oral and transdermal patch formulations), lisinopril, and olmesartan
  9. hSelect antidepressant medications included oral formulations of duloxetine, desvenlafaxine, venlafaxine, amitriptyline, desipramine, doxepin, imipramine, nortriptyline, protriptyline, clomipramine, escitalopram, citalopram, sertraline, and mirtazapine
  10. iSelect botulinum toxin medications included abobotulinumtoxinA injection, incobotulinumtoxinA injection, onabotulinumtoxinA injection, and rimabotulinumtoxinB injection. These medications were identified with NDCs on prescription claims and HCPCS on medical claims
  11. jOther medications that prevent migraines included oral formulations of carisoprodol, cyproheptadine, guanfacine, memantine, methysergide, milnacipran, and tizanidine
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The Journal of Headache and Pain

ISSN: 1129-2377

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