Factors associated with insufficient response to acute treatment of migraine in Japan: analysis of real-world data from the Adelphi Migraine Disease Specific Programme

Abstract

Background: Real-world data on sufficient/insufficient response, and predictors of insufficient response, to acute treatments for migraine are limited in Japan. This study aimed to identify factors associated with insufficient response to acute treatment of migraine by exploring significant differences between people with migraine who sufficiently/insufficiently respond to prescribed acute treatment in Japan. Methods: This was a retrospective analysis of 2014 Adelphi Migraine Disease Specific Programme cross-sectional survey data collected from physicians and their consulting adult patients with migraine in Japan. Insufficient responders to prescribed acute treatment were patients who achieved headache pain freedom within 2 h of acute treatment in no more than three of their last five migraine attacks. Factors associated with insufficient response to prescribed acute migraine treatment were identified using backward logistic regression.

Unmet Needs in Japanese Patients Who Report Insufficient Efficacy with Triptans for Acute Treatment of Migraine: Retrospective Analysis of Real-World Data

“…In contrast, this analysis of the 2017 Japan Adelphi Migraine DSP identified no significant differences in any concomitant comorbidities between TIRs and TSRs. A similar finding was reported in the 2014 Japan Adelphi Migraine DSP analysis, which aimed to identify factors associated with an insufficient response to acute medication (including but not limited to triptans) in people with migraine [8]. These differences between analyses of global and Japan Adelphi Migraine DSP data may reflect differences in the health care systems of Japan and the countries included in the global analysis.…”

“…triptans for the treatment of migraine [43] and of patients' willingness to continue with their current prescribed acute therapy for migraine [8]. In the current analysis, although a high proportion of patients reported that they were satisfied with their prescribed triptan acute medication, TIRs were more likely than TSRs to express lower levels of satisfaction, or even dissatisfaction, a finding also reported in the global analysis of 2017 Adelphi Migraine DSP data [28].…”

“…Full details of the standardized methodology used in the DSPs [21] and of the methodological details of the Japan Adelphi Migraine DSP data have been published [7,8]. Briefly, physicians completed a patient record form (PRF) for nine consecutive adult patients (aged C 18 years) with migraine, collecting information on the patient's demographics and clinical characteristics, including headache diagnoses (e.g., medication overuse, tension-type, chronic, episodic), average migraine severity over the past 3 months, average monthly attack frequency over the past 3 months, symptoms, and prescribed medication; concomitant diagnoses; and treatment history.…”

“…These included treatment-related issues-the timing of triptan administration (taking the triptan after pain had started rather than at first sign of a migraine attack) and use of OTC medication-as well as greater migraine severity during the past 3 months and lower EQ-5D-5L utility scores (indicating lower general health). Of these, only timing of acute medication was identified in the previous analysis of predictors of insufficient response to any acute migraine medication among patients in Japan [8]. Early administration of triptan medication (taking acute prescribed medication when/after pain started rather than at first sign of a migraine attack), use of OTC medication, migraine severity during the past 3 months, and EQ-5D utility scores were also identified as factors associated with response to triptan acute medication in the global analysis of 2017 Adelphi Migraine DSP data, which included a larger patient population [28].…”

“…A recent systematic review highlighted high levels of unmet needs, relating to a lack of awareness and under-diagnosis of migraine, and a need for better management and therapies for treatment, among patients with the disease in East Asia, including Japan [6]. In Japan, an increasing amount of realworld data suggests that migraine (both episodic and chronic) poses a notable disease burden and highlights high levels of unmet need with prescribed acute and preventive medication among people with migraine [7,8].…”