A Real-World Analysis of Migraine: A Cross-Sectional Study of Disease Burden and Treatment Patterns.

ObjectiveThe purpose of this cross-sectional study was to assess the sociodemographics, disease burden, and treatment patterns of patients with episodic and chronic migraine in the United States. BackgroundMigraine is a disabling neurological disease that places an enormous burden on patients. MethodsData were drawn from the Adelphi Migraine United States Disease Specific Programme (index period: January to March 2014). Physicians (N=150) completed a patient report form on 10 consulting patients with migraine. Episodic migraineurs had 14 headache days per month (HDM) and those with chronic migraine had 15. Headache-related disability was assessed with the Migraine Disability Assessment (MIDAS) questionnaire. Disability was also compared across subgroups based on the number of HDM (3, 4-7, 8-14, and 15). ResultsA total of 1487 patient report forms were completed. Over 70% of the patients were female, 90.8% (n=1350) were episodic migraineurs, and 9.2% (n=137) were chronic migraineurs. Acute treatment was prescribed for >90% of the patients, and >50% had a current prescription for preventive treatment. Despite taking acute and/or preventive treatment, 29.2% of episodic migraineurs (including some patients with 3 headache days/month) and 73.2% of chronic migraineurs had moderate-to-severe headache-related disability (MIDAS total score 11). Preventive treatment was discontinued/switched at least once by 26.4% of episodic migraineurs and by 53.3% of chronic migraineurs. Of those patients (n=382) who gave collective reasons for discontinuation/switching preventive treatment, over 70% selected lack of efficacy and tolerability/safety. ConclusionsThis real-world analysis provides additional support for the unmet medical need for efficacious therapies that reduce migraine frequency and severity, headache-related disability, and have better tolerability for patients with migraine. In addition, further research is needed to better understand the burden of illness among patients with lower migraine frequency, and to implement treatment strategies to prevent progression of the disease.