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Abstract Details

Patients With Chronic Migraine Improving to ≤4 Monthly Headache Days is an Effective Treatment Goal for Chronic Migraine
Headache
S31 - Advances in Migraine Therapeutics (3:42 PM-3:54 PM)
002

Current therapeutic goals for migraine treatment include ≥50% or ≥75% reduction in monthly migraine days (ie, responder rates). MHDs may be a more straightforward assessment tool for treatment of patients with CM.

To determine a threshold number of monthly headache days (MHDs) that clinicians can use as a therapeutic goal for patients with chronic migraine (CM).

In PROMISE-2 (NCT02974153), a randomized, double-blind study evaluating eptinezumab for the preventive treatment of CM, patients (N=1072) received eptinezumab 100mg, 300mg, or placebo on Day 0 and Week 12; all arms were pooled for analysis. Available data for 6-item Headache Impact Test (HIT-6) total score, Patient Global Impression of Change (PGIC), and days of acute medication use were combined for Weeks 4, 12, 16, and 24 and analyzed by number of MHDs (≤4, 5-9, 10-14, ≥15) during the 4 weeks preceding the respective assessment. Patient-months correspond to 4-week study intervals.

 

Of patient-months with ≤4 MHDs, 67.6% (561/830) were associated with “little to none” or “some” HIT-6 impairment, vs 47.6% (447/940), 29.9% (240/803), and 13.9% (210/1507) of patient-months with 5-9, 10-14, and ≥15 MHDs, respectively. Of patient-months with ≤4 MHDs, 85.8% (1079/1258) were associated with “very much” or “much” improved PGIC, vs 69.9% (989/1415), 49.6% (607/1224), and 21.5% (480/2229) of patient-months with 5-9, 10-14, and ≥15 MHDs, respectively. Patient-months with ≤4, 5-9, 10-14, and ≥16 MHDs used acute medication for ≥10 days on 1.9% (21/1111), 5.0% (63/1267), 49.6% (670/1351), and 74.1% (1232/1662) of patient-months, respectively.

 

In this post hoc analysis, patients improving to ≤4 MHDs achieved superior outcomes with the least acute medication use, suggesting that 4 MHDs may be a useful treatment goal for patients with CM.

Authors/Disclosures
Roger Cady (RK Consulting, LLC)
PRESENTER
Dr. Cady has received personal compensation for serving as an employee of Lundbeck. Dr. Cady has stock in Alder Biopharmaceutical.
Robert Kaniecki (The University of Pittsburgh Headache Center) Dr. Kaniecki has nothing to disclose.
Deborah Friedman Dr. Friedman has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Eli Lilly. Dr. Friedman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Lundbeck. Dr. Friedman has received personal compensation in the range of $0-$499 for serving as a Consultant for Satsuma. Dr. Friedman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Linpharma. Dr. Friedman has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Pfizer. Dr. Friedman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Axsome. Dr. Friedman 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. Friedman has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Impel. Dr. Friedman has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Abbvie. Dr. Friedman has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Neurology Reviews. Dr. Friedman has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for MedLink Neurology . The institution of Dr. Friedman has received research support from Spinal CSF Leak Foundation. Dr. Friedman has a non-compensated relationship as a Program Co-Chair, Scottsdale Headache Symposium with American Headache Society that is relevant to AAN interests or activities. Dr. Friedman has a non-compensated relationship as a Medical Advisor with Spinal CSF Leak Foundation that is relevant to AAN interests or activities. Dr. Friedman has a non-compensated relationship as a Treasurer, Board of Directors with Southern Headache Society that is relevant to AAN interests or activities.
Richard Lipton (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.
Divya Asher Divya Asher has received personal compensation for serving as an employee of Lundbeck. Divya Asher has received personal compensation for serving as an employee of AbbVie.
No disclosure on file