Patients with low or moderate-to-high frequency episodic migraine with 2 or more preventive treatment failures experienced worse quality of life and higher functional disability compared with patients who had never undergone migraine treatment, according to study findings presented at the 2022 American Headache Society (AHS) Annual Scientific Meeting, held from June 9-12, in Denver, Colorado, and virtually.

Researchers conducted a retrospective, cross-sectional study using 2019 US National Health and Wellness Survey data comparing preventive treatment use and failure among patients with either low or moderate-to-high frequency episodic migraine. Approximately 2982 patients experienced low frequency episodic migraine, while 1087 patients experienced moderate-to-high frequency episodic migraine.

The 2 patient cohorts were divided into 3 subgroups: those who had never received preventive treatment, those who experienced either 0 or 1 preventive treatment failures, and those who experienced 2 or more preventive treatment failures.


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Of the 2982 patients with low frequency episodic migraine, 604 experienced 2 or more treatment failures, 1125 experienced either 0 or 1 treatment failure, and 1253 never had preventive treatment. Of the 1087 patients with moderate-to-high frequency episodic migraine, 397 experienced 2 or more treatment failures, 334 experienced either 0 or 1 treatment failure, and 356 never had preventive treatment.

Outcome measures to assess migraine burden and patient quality of life included the Short-Form (SF)-36 Mental and Physical Component Scores and SF-6D Index, the Euro-QOL-5D (EQ5D) index, Migraine Disability Assessment (MIDAS), visual analog scale (VAS), Generalized Anxiety Disorder-7 (GAD-7), and the Patient Health Questionnaire-9 (PHQ-9). The researchers also analyzed the number of workdays missed due to migraine as well as difficulties with household activities of daily living.

Patients who are preventive naive as well as those with 0 or 1 treatment failures in the moderate-to-high frequency episodic migraine cohort scored higher on the physical component and the SF-6D index sections of the SF-36 than those with 2 or more failures (P <.001 and P <.05, respectively).

Patients who are preventive naive demonstrated higher quality of life (EQ5D; P =.003), lower disability (MIDAS; P =.001), and lower generalized anxiety (GAD-7; P <.01). This group of patients as well as those with 0-1 treatment failures reported significantly less workdays missed due to migraine and improved ability to perform household activities of daily living when compared with patients who had 2 or more failures (P <.05 and P <.01, respectively).

Patients with low frequency episodic migraine demonstrated comparable results to the moderate-to-high frequency cohort.

“Individuals with low and moderate-high episodic migraines and 2+ prior preventive treatment failures have significantly lower quality of life and higher functional impairment than individuals who are preventive naïve and have 0-1 preventive failure,” the researchers concluded.

Reference

Dodick DW, Reed ML, Way N, et al. The association between preventive treatment failure and quality of life and functioning among individuals with low- and moderate- to high-frequency episodic migraine. Presented at: AHS 2022 Annual Scientific Meeting; June 9-12, 2022; Denver, Colorado. Poster 98.