Impact of anti-CGRP monoclonal antibodies on treatment satisfaction and quality of life in patients with resistant migraine: a retrospective real-world study

Abstract

Background: Several studies have demonstrated that calcitonin gene-related peptide receptor antagonist monoclonal antibodies (anti-CGRP mAbs) are a safe and effective treatment for migraine prevention. Patients' perceptions, however, do not always match clinical findings. Numerous studies have evaluated the effects of anti-CGRP mAbs on quality of life, but few have studied treatment satisfaction. This study collected data on patient-reported satisfaction and quality of life after 1 year of anti-CGRP mAb therapy and analyzed effectiveness, safety, and adherence in routine practice. Methods: Single-center retrospective study of patients with high-frequency episodic migraine (HFEM) and chronic migraine (CM) treated for at least 1 year with the same anti-CGRP mAb. Patients were assessed using the Treatment Satisfaction Questionnaire for Medication (TSQM) at week 52 and the EuroQol 5-Dimension, 5-Level questionnaire (EQ-5D-5 L) and 6-Item Headache Impact Test (HIT-6) at weeks 0, 12, 24, and 52. Effectiveness was assessed through monthly migraine days (MMDs) and HIT-6 results, safety through reports of adverse events (AEs) and reasons for treatment discontinuation, and treatment adherence through the Medication Possession Ratio. Results: Eighty patients (95% women, mean ± SD age, 50 ± 9.9 years) with migraine (70% CM, 30% HFEM) treated with fremanezumab (88.8%), erenumab (6.2%), or galcanezumab (5%) were included. Mean global satisfaction on the TSQM was 77.2 ± 20.8 points. Treatment satisfaction was correlated with a reduction in HIT-6 score (r = 0.372, p < 0.001). At 1 year, significant improvements were observed in the EQ-5D-5L index score and visual analog scale. MMDs decreased significantly by 8.7 ± 7.4 days from baseline to week 52; 52 patients (65%) achieved a ≥ 50% reduction in MMDs. Fifty-three patients (66%) achieved a ≥ 6-point reduction on the HIT-6 (mean reduction, 12.1 ± 9.8 points); the improvement was significant (p < 0.0001) from week 12 onwards. Eighteen patients (22.5%) reported mild AEs and treatment adherence was 100%. Conclusions: Patient satisfaction with anti-CGRP mAb therapy was high in this real-world study and correlated with effectiveness measured by the HIT-6 and significantly improved quality of life. Anti-CGRP mAbs are effective and safe for resistant migraine; they have a quick onset of action and provide lasting relief.