Patterns of calcitonin gene-related peptide monoclonal antibody use in people with migraine: Results of the OVERCOME (US) study

• Published in: Cephalalgia Vol. 45; no. 6; p. 3331024251341243
• Main Authors: Ashina, Sait, Kim, Gilwan, Muenzel, E. Jolanda, Buse, Dawn C., Zagar, Anthony J., Zakharyan, Armen, Shapiro, Robert E., Nicholson, Robert A., Pearlman, Eric M., Lipton, Richard B.
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.06.2025
• Subjects: Adult; Antibodies, Monoclonal - therapeutic use; Calcitonin Gene-Related Peptide - antagonists & inhibitors; Calcitonin Gene-Related Peptide - immunology; Calcitonin Gene-Related Peptide Receptor Antagonists - therapeutic use; Cohort Studies; Female; Humans; Male; Middle Aged; Migraine Disorders - drug therapy; Migraine Disorders - epidemiology; Migraine Disorders - prevention & control; United States; United States; migraine; monoclonal antibody; CGRP; OVERCOME
• ISSN: 0333-1024; 1468-2982; 1468-2982
• DOI: 10.1177/03331024251341243

Background Understanding characteristics and reasons associated with using calcitonin gene-related peptide monoclonal antibodies (CGRP mAb) for migraine prevention may help clinicians individualize treatment plans and achieve better patient outcomes. Methods We analyzed 2019–2020 cohort data of OVERCOME (US), a population-based survey among adults with migraine. Eligible participants were categorized based on current CGRP mAb usage (“NEVER” and “EVER” users [“Continued”, “Switched” and “Discontinued”]). Machine learning techniques followed by logistic regression were used to examine, among 60 sociodemographic, clinical, migraine-related- and migraine treatment utilization characteristics, those associated with CGRP mAb use status. Results Of 39,113 participants, 25.6% had ever used migraine preventive medication(s) and 5.0% used CGRP mAbs (of which 46.1% Continued, 14.7% Switched and 39.3% Discontinued). Top factors associated with higher odds of CGRP mAb EVER vs. NEVER use were currently using recommended acute medication (odds ratio (OR) = 2.43; 95% confidence interval (CI) = 2.09–2.82) and contraindications for triptan use (OR = 2.32; 95% CI = 2.06–2.60). Continuing use vs. switching or discontinuing was most associated with current use of botulinum toxin for migraine (OR = 2.21; 95% CI = 1.42–3.44 and OR = 4.53; 95% CI = 3.14–6.55, respectively). Conclusions At the time of survey, CGRP-targeted mAbs remain underutilized for migraine and multiple characteristics are associated with CGRP mAb use patterns. Graphical abstract This is a visual representation of the abstract.