Real-world comparison of the effects of injectable CGRPs on the headache impact test in an academic family medicine clinic: a pilot study
Keywords:
migraine, chronic migraine, Headache Impact Test (HIT-6), anti-CGRP monoclonal antibodies, calcitonin gene-related peptide (CGRP)Abstract
Abstract
Background: Injectable anti-CGRP monoclonal antibodies (MABs) are increasingly used for migraine prevention. While trial data shows they reduce the average number of monthly migraine days, more real-world comparative evidence is needed to understand their impact on the Headache Impact Test (HIT-6).
Objective: Determine the efficacy of injectable anti-CGRP MABs on the HIT-6 scores in patients enrolled in the migraine clinic at multiple time intervals
Methods: This non-randomized, prospective case series involved a specific group of migraine patients who were started on injectable anti-CGRP MABs (erenumab-aaoe, fremanezumab-vfrm, and galcanezumab-gnlm), along with other recommended preventative therapies. The goal was to assess the average change in the HIT-6 score and the monthly number of migraine days compared to baseline.
Results: The primary outcome comparing the change in HIT-6 scores from baseline across the three groups showed no statistically significant differences in the mean scores at any time point (p-values of 0.8344, 0.1694, and 0.1301 for 3, 6, and 12 months, respectively). Similarly, the primary outcome comparing the change in average monthly migraine days from baseline among the three groups also revealed no significant differences in the mean at any time point (p-values of 0.5237, 0.1233, and 0.2115 for 3, 6, and 12 months, respectively).
Conclusion: Injectable anti-CGRP MABs improved HIT-6 scores and reduced the average number of monthly migraine days. However, no significant differences were observed between treatments at any time point. Despite these benefits, patients face cost-related challenges in continuing these therapies in real-world settings.
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