Predictors of Inadequate Response to Medication in Episodic Migraine: Results from American Migraine Prevalence and Prevention Study (AMPP) (P1.154)

OBJECTIVE: Estimate the proportion of persons with migraine experiencing an inadequate response to acute treatment across multiple attacks and identify the associated sociodemographic and headache features.BACKGROUND: Most migraine sufferers want pain freedom within two hours (2hPF) of taking an acute treatment for most of their attacks. The AMPP database provides a resource for assessing adequacy of acute treatment.DESIGN/METHODS: The AMPP is a longitudinal mailed survey completed in a sample selected to be representative of the US population. The 2006 AMPP survey asked persons with migraine: After taking your migraine medication are you pain free within 2-hours for most attacks? Persons who selected the response options Never, Rarely or Less than half the time had an inadequate 2hPF response while those selecting Half the time or more were considered to have an adequate 2hPF response. Binary logistic regression models assessed sociodemographics, lifestyle characteristics, headache features and treatment patterns; non-contributing variables were trimmed from the final model. Odds ratios (OR) and 95[percnt] confidence intervals (CI) are provided for significant (pu003c. 01) predictors. RESULTS: Among 8333 eligible respondents, the mean age was 47 and 82[percnt] were female. Adequate 2hPF response was achieved in 3667 (44[percnt]) participants and 4666 (56[percnt]) had inadequate 2hPF response. The significant predictors of inadequate response included higher pain intensity (OR 1.15, 95[percnt] CI 1.11-1.20), presence of allodynia (OR 1.49, 95[percnt] CI 1.34-1.65), clinical depression (OR 1.45, 95[percnt] CI 1.27-1.65), greater BMI (OR 1.09, 95[percnt] CI 1.03-1.15) and not using preventive medication (OR 0.77, 95[percnt] CI 0.65-0.92).CONCLUSIONS: A majority (56[percnt]) of migraineurs do not achieve an adequate 2hPF response. Adequacy of treatment response should be assessed in all patients, particularly those with predictors of an inadequate response. Outcomes can be improved with medications that provide rapid and consistent relief.Study Supported By: Promius Pharma Disclosure: Dr. Bennett has received personal compensation for activities with Dr. Reddy9s Laboratories/Promius Pharmaceutical company as an employee. Dr. Reed has received personal compensation for activities with Allergan, Inc., Colucid, Endo Pharmaceuticals, GlaxoSmithKline, Merck u0026 Co., Inc., NuPathe, Novartis, and Ortho-McNeil. Dr. Buse has received personal compensation for activities with Allergan, Avanir, and Eli Lilly. Dr. Buse has received research support from Allergan and Avanir. Dr. Munjal has received personal compensation for activities with Promius Pharma as an employee. Dr. Fanning has received personal compensation for activities with Allergan, Inc., Endo Pharmaceuticals, GlaxoSmithKline, MAP Pharmaceuticals, Merck u0026 Co., Inc., NuPathe, Novartis, and Ortho-McNeil. Dr. Lipton has received personal compensation for activities with Allergan, American Headache Society, Autonomic Technologies, Boston Scientific, Bristol Myers Squibb, Cognimed, Colucid, Eli-Lilly, eNeura Therapeutics, Merck, Novartis, Pfizer, Teva, and V