Calcitonin gene-related peptide (CGRP) antagonists are recommended by NICE as 4th line migraine preventive treatment. We report the frequency and preventive treatment patterns of migraine in the UK, focusing on adult patients who cease ≥3 oral preventive medications.Methods
Study populations were retrieved from the Clinical Practice Research Datalink GOLD database (study period: 19/09/2012–01/01/2020; inclusion criteria: ≥12 months follow-up, current-in-dataset, adult on 01/01/2020). Patients who used ≥1 oral preventive medication with ≥3-year follow-up after first pre- scription were considered preventive users; medication/class cessation was defined as cessation with no evidence of restart within 6 months from end-of-supply date.Results
On 01/01/2020, 30.5/1,000 (n=81,190/2,664,306, 95% CI 30.3–30.7) of study population had ≥1 migraine codes recorded over the study period. 42% of patients were preventive users. Of these, 10% had ≥3 preventive medication cessations, and 8% had ≥3 preventive medication class cessations. Patients with ≥3 preventive medication cessations were mostly female (83%), mean age was 46 years and 22% had a referral to a neurologist during the study period.Conclusions
A considerable proportion of patients with migraine cease ≥3 lines of oral preventive medi- cation, pointing to the need for additional therapeutic options.