Abstract Details

Title Real-world Switching Rates of Atogepant Are Lower than CGRP Monoclonal Antibodies (mAbs) in Patients with Migraine Using Claims Database

Topic Headache

Presentation(s) P4 - Poster Session 4 (11:45 AM-12:45 PM)

Poster/Presentation
Number 12-008

Background CGRP mAbs and atogepant, an oral CGRP antagonist, are approved in the US and EU for the preventive treatment of migraine. Switching treatments is an indicator of unmet treatment needs and associated with incremental direct medical costs.

Objective To understand the real-world treatment switch rates of atogepant versus calcitonin gene-related peptide monoclonal antibodies (CGRP mAbs) using claims data from the United States.

Design/Methods Adult migraine patients newly initiating atogepant or a CGRP mAb between 10/2022 and 6/2023 were identified from the Merative MarketScan database. The earliest treatment claim was the index date. Patients were excluded if they had ≥1 claim for atogepant, rimegepant, BOTOX for migraine, or a CGRP mAb in the 12 months preceding the index date. A switch was defined by the occurrence of ≥1 claim for a different branded preventive treatment (atogepant, CGRP mAb, or BOTOX) during the 12 months following the index date. Multivariable logistic regression models were used to compare odds of switching between atogepant and CGRP mAbs.

Results Based on a 12-month follow-up, the study included 641 patients who initiated treatment with atogepant and 3,594 with a CGRP mAb (26 eptinezumab, 1,041 erenumab, 917 fremanezumab, and 1,610 galcanezumab). Baseline demographics and clinical characteristics were comparable across treatments; 37% of atogepant and 42% of CGRP mAb users had a chronic migraine diagnosis. At 12 months follow-up, 13.4% of atogepant users and 21.1% of CGRP mAb users (23.1% eptinezumab, 26.5% erenumab, 19.6% fremanezumab, 18.4% galcanezumab) initiated a different branded preventive. Patients taking CGRP mAbs had significantly higher odds of switching to another branded preventive compared to patients taking atogepant (Odds Ratio 1.72, 95% CI: 1.35, 2.21).

Conclusions Compared with atogepant users, CGRP mAb users were significantly more likely to switch to another branded preventive treatment within 1 year of treatment initiation.

Authors/Disclosures
Karen Carr, PhD PRESENTER	Dr. Carr has nothing to disclose.
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.
Pranav Gandhi	Pranav Gandhi has received personal compensation for serving as an employee of AbbVie. Pranav Gandhi has stock in AbbVie Inc.
Lauren Wilson	No disclosure on file
Sarah Ayton	No disclosure on file
Kandavadivu Umashankar (AbbVie)	No disclosure on file
Molly Duan (Abbvie)	No disclosure on file
Jessica Ailani, MD, FAAN (Medstar Georgetown Neurology)	Dr. Ailani has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for Allergan/Abbvie. Dr. Ailani has received personal compensation in the range of $0-$499 for serving as a Consultant for Amgen. Dr. Ailani has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Eli Lilly. Dr. Ailani has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Lundbeck. Dr. Ailani has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Satsuma. Dr. Ailani has received personal compensation in the range of $500-$4,999 for serving as a Consultant for GlaxoSmithKline. Dr. Ailani has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Pfizer. Dr. Ailani has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Gore. Dr. Ailani has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Ipsen. Dr. Ailani has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merz. Dr. Ailani has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Theranica. Dr. Ailani has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Neurolief. Dr. Ailani has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Scilex. Dr. Ailani has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Dr. Reddy. Dr. Ailani has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Linpharma. Dr. Ailani has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eneura. Dr. Ailani has received personal compensation in the range of $50,000-$99,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Allergan/Abbvie. Dr. Ailani has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Aeon. Dr. Ailani 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. Ailani has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Linpharma. Dr. Ailani has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Aeon. Dr. Ailani 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 Report. Dr. Ailani has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Medscape. The institution of Dr. Ailani has received research support from Satsuma. The institution of Dr. Ailani has received research support from Ipsen. The institution of Dr. Ailani has received research support from Parema. Dr. Ailani has received personal compensation in the range of $500-$4,999 for serving as a Medical Advisor with SELF.