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Table 5 Dose equivalent changes in traditional acute migraine medications among continuing users 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

Dose equivalent changes for triptans

Pre-index triptan use, n (%)

36,054 (45.9)

14,182 (53.2)

21,872 (42.1)

Patients with pre-index AND post-index triptan use, n (%)

20,677 (57.4)

9,081 (64.0)

11,596 (53.0)

Patients with continuing use of triptansb, n (%)

14,012 (67.8)

6,395 (70.4)

7,617 (65.7)

Pre-index dose per month, sumatriptan mg equivalentsc, among patients with continuing use of triptans, mean (SD) [median]

911 (891) [750]

993 (930) [800]

843 (851) [650]

Post-index dose per month, sumatriptan mg equivalentsc, among patients with continuing use of triptans, mean (SD) [median]

885 (854) [700]

951 (889) [750]

830 (820) [600]

Differenced sumatriptan mg equivalents per month,c mean (SD)

-26 (547)

-42 (563)

-13 (534)

Relative differencee

-2.9%

-4.2%

-1.5%

Dose equivalent changes for opioids

Pre-index opioid use, n (%)

29,692 (37.8)

11,116 (41.7)

18,576 (35.8)

Patients with pre-index AND post-index opioid use, n (%)

20,745 (69.9)

8,121 (73.1)

12,624 (68.0)

Patients with continuing use of opioidsb, n (%)

16,135 (77.8)

6,434 (79.2)

9,701 (76.8)

Pre-index dose per month, morphine mg equivalentsc, among patients with continuing use of opioids, mean (SD) [median]

1,191 (2,586) [450]

1,124 (2,315) [450]

1,236 (2,751) [455]

Post-index dose per month, morphine mg equivalentsc, among patients with continuing use of opioids, mean (SD) [median]

1,252 (2,601) [515]

1,165 (2,263) [500]

1,310 (2,801) [525]

Differenced morphine mg equivalents per month,c mean (SD)

61 (997)

41 (835)

74 (1,091)

Relative differencee

5.1%

3.6%

6.0%

Dose equivalent changes for ergots

Pre-index ergot use, n (%)

1,255 (1.6)

718 (2.7)

537 (1.0)

Patients with pre-index AND post-index ergots, n (%)

501 (39.9)

300 (41.8)

201 (37.4)

Patients with continuing use of ergotsb, n (%)

278 (55.5)

162 (54.0)

116 (57.7)

Pre-index dose per month, ergotamine mg equivalentsc, among patients with continuing use of ergots, mean (SD) [median]

11.4 (12.5) [8.0]

11.1 (10.6) 

11.8 (14.7) [8.0]

Post-index dose per month, ergotamine mg equivalentsc, among patients with continuing use of ergots, mean (SD) [median]

12.4 (12.9) [10.0]

12.6 (10.4) [10.0]

12.2 (15.8) [8.0]

Differenced ergotamine mg equivalents per month,c mean (SD)

1.0 (6.8)

1.4 (6.3)

0.4 (7.3)

Relative differencee

8.8%

12.8%

3.7%

  1. mAb monoclonal antibody, SD standard deviation
  2. aPrior mAb (erenumab, galcanezumab, fremanezumab) use was evaluated during the 6-month period prior to the index date
  3. bContinuing users were patients with use of the acute medications in the pre-index and who did not discontinue acute medication in the post-index period. Discontinuation 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. cDose in mg equivalents per month was calculated as the sum of quantity multiplied by the dose equivalent strength for claims during the 6-month period divided by 6 months
  5. dDifference was calculated as the post-index value minus the pre-index value. Negative values represent a reduction in the post-index period while positive values represent an increase in the post-index period
  6. eRelative change was calculated as (post-index mean dose—pre-index mean dose)/pre-index mean dose *100%
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The Journal of Headache and Pain

ISSN: 1129-2377

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