Patients Using Medication for Migraine Still Have Unmet Treatment Needs, Survey Says

In a large survey of patients with migraine taking an oral, acute prescription migraine medication, most had unmet needs, according to survey results presented recently at the annual meeting of the American Academy of Neurology.

The data came from the Migraine in America Symptoms and Treatment (MAST) Study, a longitudinal, internet-based panel study of symptoms, approaches to management, and unmet treatment needs among US adults with migraine.

Using a sample of MAST study participants, this particular study described areas of unmet treatment needs and assessed rates of migraine-related disability.

A validated migraine screener used modified International Classification of Headache Disorders-3 beta criteria to identify adults with migraine. Respondents

averaging 1 or more headache day per month over the previous 3 months and those using acute oral migraine medications were included. They were excluded if they used nasal or injectable treatments.

Respondents submitted data about age, gender, race, income, employment, education, body mass index, health insurance, smoking status, marital status, medication use and response, migraine symptoms, and migraine-related disability.

Fifteen characteristics of “unmet needs” were grouped into 3 domains based on item face validity and clinician judgment (inadequate treatment response, demanding attack characteristics, and unique patient characteristics). Researchers also administered the 13-item MAST Unmet Treatment Needs questionnaire.

Among 15,133 respondents with migraine, 26% (n = 3930) reported use of oral acute prescription medications. The oral prescription sample had a mean [SD] age of 45 [13.5] years. Nearly 75% were women and most were white.

The majority of respondents had at least 1 unmet need (95.8%), reported unmet needs related to demanding attack characteristics (89.5%), or had unmet needs related to inadequate treatment response (74.1%). But only 16.1% reported unique patient characteristic unmet needs.

Common unmet needs included rapid onset of headache (65.3%), headache-related disability (55.6%), inadequate 2-hour pain freedom (49%), and pain recurrence within 24 hours (38.6%).

The MAST study is sponsored by Promius Pharma, maker of a sumatriptan nasal spray for migraine.

Reference

Reed M, Lipton R, Munjal S, et al. Assessing unmet treatment needs and associated disability in persons with migraine: results from Migraine in America Symptoms and Treatment (MAST) study. Presented at: 71st American Academy of Neurology Annual Meeting (AAN); May 4-10, 2019; Philadelphia, PA.