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Abstract Details

Use of predictive modeling to determine treatment-response to OTC Medications in Acute Migraine: Results from the American Migraine Prevalence and Prevention Study (AMPP)
Headache
Headache Posters (7:00 AM-5:00 PM)
054

Pain freedom and sustained relief are important priorities in the acute treatment of migraine.  Some OTC drugs are widely used and approved for migraine.

To identify predictors of acute treatment optimization with over-the-counter (OTC) medications among people with migraine.

Eligible individuals responded to the 2006 AMPP survey, were age ≥18, met criteria for migraine, had <15 monthly headache days, did not take prescription medication for migraine, and used ≥1 of the following acute migraine medications: acetaminophen, aspirin, NSAIDs, or caffeine combination products (CCP). The Migraine Treatment Optimization Questionnaire-6 (mTOQ-6), was used to assess acute treatment optimization. Adequate 2-hour pain freedom (2hPF) and 24-hours pain relief (24hPR) were defined by a response to treatment ≥half the time at 2h and 24h post treatment, respectively. Multivariate logistic regression models were carried out to identify predictors of response to acute migraine treatment and to develop predictive models, which can estimate probability of treatment-response to each class of OCT medications.

Among 3852 participants, mean age was 45.0 years (SD=12.8), 79.0% were female, 41.5% reported adequate 2hPF and 44.6% 24hPR. Adequate treatment response was significantly predicted by lower average headache pain intensity (2hPF, OR=0.83, 95%CI 0.79-0.87; 24hPR, OR=0.85, 95%CI 0.81-0.90), cutaneous allodynia (ASC-12) (2hPF, OR=0.73, 95%CI 0.61-0.87; 24hPR, OR=0.63, 95%CI 0.50-0.76, and depression (PHQ-9) (2hPF, OR=0.69, 95%CI 0.55-0.88; 24hPR, OR=0.57, 95%CI 0.45-0.72). Lower migraine symptom severity score (MSSS) was predictive of Adequate 2hPF (OR=0.93, 95%CI 0.91-0.96) and fewer monthly headache days was predictive of Adequate 24hPR (OR=0.92, 95%CI 0.89-0.94). Among participants reporting OTC monotherapy, individuals taking CCP were more likely to have Adequate 2hPF (OR=1.55, 95%CI 1.23-1.95) and 24hPR (OR=1.79, 95%CI 1.18-1.88) in comparison with those taking acetaminophen.

Most participants were not optimized on OTC acute treatments. Predictive models identify responders.   

Authors/Disclosures
Ali Ezzati, MD (University of California, Irvine)
PRESENTER
Dr. Ezzati has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Mist Research. Dr. Ezzati has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for BioDelivery Sciences International (BDSI) . The institution of Dr. Ezzati has received research support from NIA. The institution of Dr. Ezzati has received research support from Alzheimer's Association. The institution of Dr. Ezzati has received research support from Cure Alzheimer's Fund.
Kristina M Fanning, PhD (MIST Reserach) The institution of Kristina Fanning has received research support from Abbvie. The institution of Kristina Fanning has received research support from NYC Langone Health . The institution of Kristina Fanning has received research support from Allay Lamp. The institution of Kristina Fanning has received research support from Juva Health.
Dawn C. Buse, PhD (Dawn C. Buse, PhD) Dr. Buse has received personal compensation for serving as an employee of Vector Psychometric Group. Dr. Buse has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbvie-Allergan. Dr. Buse has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Amgen. Dr. Buse has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Lilly. Dr. Buse has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Lundbeck. Dr. Buse has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Collegium. Dr. Buse has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Teva. Dr. Buse has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Lilly. Dr. Buse has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Abbvie-Allergan. Dr. Buse has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Lundbeck. Dr. Buse has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Current Pain and Headache Reports. The institution of Dr. Buse has received research support from Amgen. The institution of Dr. Buse has received research support from FDA. The institution of Dr. Buse has received research support from National Headache Foundation.
Jelena M. Pavlovic, MD, PhD (Albert Einstein College of Medicine) Dr. Pavlovic has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biohaven.
Michael L. Reed, PhD (Vedanta Research) The institution of Dr. Reed has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Eli Lilly. The institution of Dr. Reed has received research support from Allergan. The institution of Dr. Reed has received research support from Dr Reddy's Labs/Promius. The institution of Dr. Reed has received research support from Allay Lamp. Dr. Reed has a non-compensated relationship as a Research Analyst with National Headache Foundation that is relevant to AAN interests or activities.
Richard B. Lipton, MD, FAAN (Albert Einstein College of Medicine) Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Allergan/Abbvie. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Amgen. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Biohaven. Dr. Lipton has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for Eli Lilly. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Lundbeck. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for GlaxoSmithKline. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Teva. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Vedanta. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Grifols. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Pfizer. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Axon. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Satsuma. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Cool Tech. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BDSI. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Linpharma. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Allergan/Abbvie. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biohaven. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Eli Lilly. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Lundbeck. Dr. Lipton has stock in Biohaven. Dr. Lipton has stock in Manistee. Dr. Lipton has stock in Axon. Dr. Lipton has stock in CoolTech. The institution of Dr. Lipton has received research support from Teva. The institution of Dr. Lipton has received research support from Amgen. The institution of Dr. Lipton has received research support from Allergan/Abbvie. The institution of Dr. Lipton has received research support from Gammacore. The institution of Dr. Lipton has received research support from Axsome. The institution of Dr. Lipton has received research support from Charleston Labs. The institution of Dr. Lipton has received research support from Eli Lilly. The institution of Dr. Lipton has received research support from Satsuma. The institution of Dr. Lipton has received research support from NIH . The institution of Dr. Lipton has received research support from Veterans Administration. Dr. Lipton has received publishing royalties from a publication relating to health care.