CGRP inhibitor use increased from 11.8 to 22.4 incident and 57.3 prevalent per 100,000 adults from 2018 to 2023, reducing days for acute medication by 16 days post-initiation.
Does prophylactic CGRP inhibitor initiation reduce migraine-related acute medication and healthcare use in adults with migraine?
Initiation of CGRP inhibitors in a real-world Canadian cohort was associated with a significant reduction in migraine-related acute medication use and healthcare visits, despite high rates of concomitant prophylactic medication use.
Absolute Event Rate: 0% vs 0%
ABSTRACT Background: A better understanding of calcitonin gene-related peptide (CGRP) inhibitor use is in migraine treatment needed. Methods: A retrospective, observational, population-based cohort study was conducted using administrative data. Adults (≥18 years) who received ≥1 prophylactic CGRP inhibitor in Canada (six provinces) between 2018 (first approved) and 2023 were identified. CGRP inhibitor use was described; migraine-related acute medication and healthcare use were compared pre–post CGRP inhibitor initiation (independent and paired t -tests). Results: 12,851 adults were identified. CGRP inhibitor use increased from 11.8 (incident/prevalent) to 22.4 (incident) and 57.3 (prevalent) per 100,000 adults. Erenumab use decreased over time, as use of newer agents increased. During the 1-year period after CGRP inhibitor initiation, 57.4% had concomitant use with a different prophylactic migraine medication class (onabotulinumtoxinA injection: 23.2%; oral non-CGRP inhibitor: 34.2%), and 30.4% stopped use (21.3% switched to a different prophylactic migraine medication class; 9.1% discontinued all prophylactic migraine medication). During the 1-year period after CGRP inhibitor initiation (versus before), days of supply for migraine-related acute medication was lower (mean standard deviation: 129 191 versus 145 197 days; mean difference 95% confidence interval: −16: −22, −11 days), as were the number of healthcare visits (7.36 8.70 versus 9.18 10.10; −1.82 −2.06, −1.58). Conclusion: CGRP inhibitor use increased from 2018 to 2023. After CGRP inhibitor initiation, most patients had concomitant use with a different prophylactic migraine medication class, and some stopped use; migraine-related acute medication and healthcare use were lower (versus before). Findings provide a real-world description of the evolving landscape of CGRP inhibitor use in Canada.
Randall et al. (Fri,) reported a other. CGRP inhibitor use increased from 11.8 to 22.4 incident and 57.3 prevalent per 100,000 adults from 2018 to 2023, reducing days for acute medication by 16 days post-initiation.