Patterns of anti-CGRP mAbs use and variation of triptan consumption following treatment initiation : A descriptive drug utilization study in the Tuscany region, Italy

© 2023 American Headache Society..

OBJECTIVE: To describe the pattern of anti-calcitonin gene-related peptide monoclonal antibodies (anti-CGRP mAbs) utilization in the Tuscany region, Italy, and the variation of triptan consumption after treatment initiation.

BACKGROUND: Given the recent commercialization of anti-CGRP mAbs as migraine preventive medications, real-world evidence on their patterns of utilization and their impact on migraine abortive medication use is still limited.

METHODS: A retrospective, descriptive, cohort study on the real-world utilization of anti-CGRP mAbs was performed using the population-based regional administrative database of Tuscany. Patients with ≥1 anti-CGRP mAb dispensing (namely erenumab, galcanezumab, fremanezumab) between April 1, 2019, and September 30, 2021, were identified. The first dispensing was the cohort entry (CE). New users (NUs) were patients with no anti-CGRP mAb dispensing before CE. Kaplan-Meier (KM) curves were plotted to describe the cumulative probability of remaining with the initial anti-CGRP mAb during a 15-month follow-up period as a measure of treatment persistence. Among NUs with ≥2 triptan dispensings during the 6 months before CE (i.e., baseline), the mean monthly number of triptan dosage units dispensed was measured in five consecutive follow-up time windows (months 1-3, 4-6, 7-9, 10-12, 13-15) and the difference from the baseline was calculated.

RESULTS: A total of 624 NUs (erenumab = 295, galcanezumab = 223, fremanezumab = 106) were identified, of whom 188 (78%) were women. Mean age was 49.2 years (standard deviation [SD] = 12.6). The survival to discontinuation at 6, 12, and 15 months was about 69%, 48%, and 6%, respectively. The survival to switch was about 6% at 15 months. The observed variation of triptan consumption at 3/6/9/12/15 months and the corresponding SD was -4.4 [8.2]/-5.2 [9.0]/-5.5 [9.2]/-5.4 [9.2]/-4.5 [10.0], respectively.

CONCLUSION: Patient demographics reflect the place of these medications in therapy. Overall, findings seem to indicate a favorable tolerability and effectiveness profile. Further studies are warranted to better establish the long-term comparative effectiveness, safety, and cost effectiveness of anti-CGRP mAbs compared to other preventive medications.

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - volume:63

Enthalten in:

Headache - 63(2023), 10 vom: 13. Nov., Seite 1391-1402

Sprache:

Englisch

Beteiligte Personen:

Hyeraci, Giulia [VerfasserIn]
Paoletti, Olga [VerfasserIn]
Iannone, Luigi Francesco [VerfasserIn]
Gini, Rosa [VerfasserIn]
De Cesaris, Francesco [VerfasserIn]
Geppetti, Pierangelo [VerfasserIn]
Roberto, Giuseppe [VerfasserIn]

Links:

Volltext

Themen:

Anti-calcitonin gene-related peptide monoclonal antibodies
Antibodies, Monoclonal
Journal Article
Migraine
Migraine preventive medications
Pharmacoutilization
Serotonin 5-HT1 Receptor Agonists
Triptan consumption

Anmerkungen:

Date Completed 01.12.2023

Date Revised 01.12.2023

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1111/head.14639

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM363238980