ELEVATE PREVENTIVE MIGRAINE MANAGEMENT
How do you know if your patient is doing well on their preventive treatment?
Learn more about how to assess whether your patients are optimized, and the recommendations for first-line approaches to prevention.
Stop the cycle
50% of patients, the majority of which were on an oral generic, still met the criteria for needing a preventive treatment, suggesting inadequate benefit from their current regimen.2
Migraine patients who have cycled through more than one preventive treatment may encounter higher rates of the following:
2. Buse DC, Sakai F, Matharu M, et al. Characterizing gaps in the preventive pharmacologic treatment of migraine: Multi-country results from the CaMEO-I study. Headache. 2024;64(5):469-481. doi:10.1111/head.14721
Discontinuing or switching two or more classes of preventive treatment (including oral generics) significantly increases total direct healthcare costs.2
2. Ford JH, Schroeder K, Nyhuis AW, Foster SA, Aurora SK. Cycling through migraine preventive treatments: implications for all-cause total direct costs and disease-specific costs. J Manag Care Spec Pharm. 2019;25(1):46-59.
Migraine patients requiring more drug-class switches appeared to have increased use of acute medications, with opioid use being the highest. 2
2. Ford JH, Schroeder K, Nyhuis AW, Foster SA, Aurora SK. Cycling through migraine preventive treatments: implications for all-cause total direct costs and disease-specific costs. J Manag Care Spec Pharm. 2019;25(1):46-59.
Among individuals with migraine who have taken more than one preventive treatment, 76% are exhausted with the cycle of hoping for success followed by failure.3
3. National Headache Foundation. Preventing migraine attacks: a current perspective. Accessed 08, 2024. https://headaches.org/wp-content/uploads/2021/05/NHF-Preventing-Migraine-Attacks-Report-Updated-Reference-2021MAY10.pdf
American Headache Society's goals for preventive therapy
Improve
Reduce
What to consider for your patients on prevention
Watch Dr. Hope O’Brien discuss the importance of migraine prevention and treatment optimization for healthcare providers.
Did you know?
Migraine can be a progressive disease, meaning it may worsen over time if not adequately treated. And one of the strongest risk factors for progression is a higher frequency of monthly headache days.
This can be concerning, because we know higher monthly headache days may mean more disability for patients.
Thankfully, preventive therapy can help reduce both monthly migraine days and disability.
Hi, I’m Dr. Hope O’Brien, Founder and CEO of Headache Center of Hope and a paid consultant of AbbVie.
Did you know the American Headache Society now recommends migraine-specific treatments, such as CGRP antagonists, as a first line option for prevention?
We know so much more about what is happening in the brain during the migraine attack now than we did decades ago when all that was available for prevention were treatments originally developed for other diseases.
Migraine-specific treatments, on the other hand, were both designed and approved for migraine.
CGRP antagonists are migraine-specific treatments that target an inflammatory neuropeptide we now know has an established role in the pathophysiology of the disease.
There is robust evidence for migraine-specific preventive treatments, including efficacy and safety across both episodic and chronic migraine.
These trials also support efficacy beyond migraine day reduction through a newfound emphasis on patient reported outcomes, function, and quality of life.
For example, most migraine-specific treatment options have data on:
- The ability to perform daily activities
- Interictal burden
- Non-headache symptoms like the ability to concentrate or think clearly
The reason I get excited about these data is that they more closely resemble clinical practice. When I talk to my patients, I make sure to ask: “How is migraine still impacting your life?”
And based on their response, that helps inform when my patient and I may need to have a conversation about optimizing their preventive treatment.
So talk to your patients about how they are doing on their migraine preventive. And if you haven’t checked it out yet, read the AHS Position Statement, and consider migraine-specific therapies as a first line option.
Dr. Hope O'Brien
Dr. Hope O'Brien is a paid consultant of AbbVie.How are you assessing the impact migraine
impacts your patients’ lives?
Patient-Reported Outcomes (PRO) Domains
Leisure
activities
Relationships
& social activities
Home activities,
errands & chores
Tiredness
& energy levels
Concentration
& clear thinking
Physical activity,
body movement
Work activities &
productivity
Migraine can disrupt many facets of daily life.
How are you checking in?
Take a look through this guide for considerations that can enable
you to have meaningful discussions with patients about their overall well-being.1
Function Discussion Guide
1. AbbVie. (2024). Migraine can disrupt many facets of daily life:
How are you checking in? [Patient education guide].
Why does function matter?
Watch Dr. Christopher Gottschalk discuss the functional impairments that can impact migraine patients.
Hello, I’m Dr. Christopher Gottschalk.
I’m a board-certified neurologist and headache specialist, and President of the Alliance for Headache Disorders Advocacy, AHDA.
Migraine is one of the most common diseases in the world, affecting about 1 billion people worldwide. But did you know, according to the Global Burden of Disease study, migraine is the leading cause of disability in people under 50 years of age?
In fact, migraine causes more years lived with disability than all other neurological disorders combined.
Reduction in migraine days is typically used as an important primary endpoint, although this endpoint does not capture what matters most to patients and providers: quality of life.
Now, let’s look at data from the CaMEO analysis which shows:
- 1 out of 3 have had their careers impacted by migraine
- Almost 40% feel they would be a better parent if they did not have migraine
- Nearly half feel they would be a better partner if they did not have headaches
Recent trials have begun to assess the impact of preventive therapy on validated patient-reported outcome measures, PROMS, assessing migraine-related quality of life. Such as:
- MSQ
- MIDAS
And countless others. Now, healthcare providers can focus on choosing the preventive therapy that may improve the everyday well-being of their patients. As healthcare providers, we can shift the dialogue with our patients and focus on:
- How migraine impacts important PRO domains like: Home, Activities, Energy Levels, Concentration & clear thinking, Physical Activity, Work Activity, and Social Activities
- Discussing how early and significantly treatment can impact quality of life, using at least one of these PRO domains in a post-treatment follow-up discussion and asking the question: What have you been able to do that you couldn’t do before you started this treatment?
To recap, migraine is not just a numbers game: the true goal is to improve a person’s overall quality of life. Patient Reported Outcomes are the future of migraine research, and the increased focus on functional outcomes has the potential to dramatically impact treatment decisions and improve provider and patient understanding.
