目的:评估在美国启动抗降钙素基因相关肽(CGRP)途径单克隆抗体(mAb)erenumab后12个月随访期间偏头痛急性和预防性药物的实际使用变化。
背景:在开始使用erenumab后,对偏头痛的急性和预防性药物的实际使用的早期评估仅限于6个月的随访。
方法:这项回顾性队列研究使用了IQVIA开源纵向处方(LRx)和医疗(Dx)索赔数据库的数据。确定了2018年5月至2020年4月之间对erenumab的初始索赔(索引日期)的成年患者。
结果:在符合纳入标准的201,176例患者中,平均(标准差[SD])年龄为47.5(13.8)岁,女性占85.6%(n=172,153)。大多数患者在12个月的预索引期间使用一种或多种急性(88.4%;n=177,795)和一种或多种传统的预防性(86.1%;n=173,225)药物。坚持erenumab(覆盖天数的比例[PDC]≥0.80)为40.2%(n=80,927),总平均(SD)PDC为0.60(0.34)。在所有患者中,70.0%(n=140,809)停用erenumab。在占24.7%(n=49,720)的患者重新启动erenumab后,在45.3%(n=91,089)的患者中观察到停药而不重新开始.在13.1%(n=26,446)的总患者中观察到转换到不同的抗CGRP途径mAb。在177,795名患者中,预索引使用一种或多种急性偏头痛药物类别,86.5%(n=153,788)有同一类别的索引后使用,在12个月的随访期内,其中56.7%(87,134/153,788)的患者停止了一种或多种急性药物治疗。同样,在173,225名患者中,使用了一种或多种传统的偏头痛预防药物,67.7%(n=117,274)的指数后使用了同一类别,在12个月的随访期内,其中46.7%(54,790/117,274)的患者停止了一种或多种传统预防药物。
结论:在这项长期研究中,我们观察到,在开始使用erenumab后,偏头痛的急性和预防性药物均停药.
OBJECTIVE: To assess changes in real-world use of acute and preventive medications for migraine over a 12-month follow-up period in the United States following initiation of the anti-calcitonin gene-related peptide (CGRP) pathway monoclonal antibody (mAb)
erenumab.
BACKGROUND: Early assessments of real-world use of acute and preventive medications for migraine after initiation of
erenumab have been limited to 6 months of follow-up.
METHODS: This retrospective cohort study used data from the IQVIA open-source longitudinal prescription (LRx) and medical (Dx) claims databases. Adult patients with an initial claim (index date) for
erenumab between May 2018 and April 2020 were identified.
RESULTS: Among 201,176 patients who met inclusion criteria, the mean (standard deviation [SD]) age was 47.5 (13.8) years and 85.6% (n = 172,153) were female. Most patients used one or more acute (88.4%; n = 177,795) and one or more traditional preventive (86.1%; n = 173,225) medications during the 12-month pre-index period. Adherence to
erenumab (proportion of days covered [PDC] ≥0.80) was 40.2% (n = 80,927) with an overall mean (SD) PDC of 0.60 (0.34). Among all patients, 70.0% (n = 140,809) discontinued
erenumab. After accounting for 24.7% (n = 49,720) of patients who restarted erenumab, discontinuation without reinitiation was observed in 45.3% (n = 91,089) of total patients. Switching to a different anti-CGRP pathway mAb was observed in 13.1% (n = 26,446) of total patients. Among 177,795 patients with pre-index use of one or more acute migraine medication class, 86.5% (n = 153,788) had post-index use of the same class, and 56.7% (87,134/153,788) of them discontinued one or more class of acute medication in the 12-month follow-up period. Similarly, among 173,225 patients with pre-index use of one or more traditional migraine preventive medication class, 67.7% (n = 117,274) had post-index use of the same class, and 46.7% (54,790/117,274) of them discontinued one or more class of traditional preventive medication in the 12-month follow-up period.
CONCLUSIONS: In this long-term study, we observed the discontinuation of both acute and preventive medications for migraine post-erenumab initiation.