Table 1.
Baseline characteristics of 69,589 patients who initiated topiramate or anti-CGRP treatment for migraine prevention between May 17th 2018 and February 28th 2023
| Non-hypertensive | Hypertensive | |||
|---|---|---|---|---|
| Anti-CGRP | Topiramate | Anti-CGRP | Topiramate | |
| (n = 10,759) | (n = 32,224) | (n = 8,121) | (n = 18,485) | |
| Age, mean (SD), y | 43.4 (10.5) | 40.7 (10.6) | 54.4 (11.2) | 53.6 (11.8) |
| Gender a, women (%) | 5,507 (51.2) | 12,907 (40.1) | 2,623 (32.3) | 4,394 (23.8) |
| Race a (%) | ||||
| White | 7,214 (67.1) | 18,403 (57.1) | 5,209 (64.1) | 10,122 (54.8) |
| Black | 2,218 (20.6) | 9,327 (28.9) | 2,206 (27.2) | 6,524 (35.3) |
| Asian | 147 (1.4) | 690 (2.1) | 90 (1.1) | 278 (1.5) |
| Others/Unknown b | 1,180 (11.0) | 3,804 (11.8) | 616 (7.6) | 1,561 (8.4) |
| Ethnicity a, non-Hispanics (%) | 9,576 (89.0) | 28,026 (87.0) | 7,485 (92.2) | 17,013 (92.0) |
| Service connection, yes (%) | 10,370 (96.4) | 30,641 (95.1) | 7,530 (92.7) | 16,600 (89.8) |
| Rurality (%) | ||||
| Urban | 7,616 (70.8) | 23,796 (73.8) | 5,579 (68.7) | 12,676 (68.6) |
| Rural | 3,122 (29.0) | 8,320 (25.8) | 2,537 (31.2) | 5,769 (31.2) |
| Unknown | 21 (0.2) | 108 (0.3) | 5 (0.1) | 40 (0.2) |
| Smoking status (%) | ||||
| Never | 5,711 (53.1) | 16,125 (50.0) | 3,976 (49.0) | 8,045 (43.5) |
| Current | 3,083 (28.7) | 10,097 (31.3) | 2,370 (29.2) | 6,528 (35.3) |
| Former | 1,921 (17.9) | 5,630 (17.5) | 1,770 (21.8) | 3,885 (21.0) |
| Unknown | 44 (0.4) | 372 (1.2) | 5 (0.1) | 27 (0.1) |
| BMI, mean (SD), kg/m2 | 30.2 (5.8) | 30.7 (5.8) | 32.5 (6.2) | 33.0 (6.4) |
| Underweight/Normal | 1,912 (17.8) | 4,797 (14.9) | 752 (9.3) | 1,511 (8.2) |
| Overweight | 3,650 (33.9) | 10,712 (33.2) | 2,208 (27.2) | 4,897 (26.5) |
| Obese | 5,054 (47.0) | 16,096 (50.0) | 5,145 (63.4) | 12,013 (65.0) |
| Unknown | 143 (1.3) | 619 (1.9) | 16 (0.2) | 64 (0.3) |
| Systolic BP, mean (SD), mm Hg | 121.8 (12.8) | 122.6 (12.8) | 130.1 (15.4) | 131.7 (15.6) |
| Diastolic BP, mean (SD), mm Hg | 77.5 (8.9) | 77.3 (9.0) | 80.3 (9.7) | 80.8 (10.1) |
| Years since onset of migraine, mean (SD) | 5.0 (4.2) | 1.9 (3.1) | 6.4 (4.5) | 3.0 (4.0) |
| Chronic migraine (%) | 5,507 (51.2) | 5,170 (16.0) | 4,545 (56.0) | 3,250 (17.6) |
| Headache-related encounters in the past year | ||||
| Primary care, mean (SD) | 1.2 (1.3) | 0.9 (1.0) | 1.2 (1.5) | 0.8 (1.0) |
| Emergency room, mean (SD) | 0.2 (0.9) | 0.1 (0.4) | 0.2 (1.1) | 0.1 (0.5) |
| Neurology, mean (SD) | 2.3 (2.3) | 0.4 (0.9) | 2.4 (2.4) | 0.5 (1.0) |
| Prescribed Triptans (%) | 8,638 (80.3) | 14,624 (45.4) | 5,860 (72.2) | 7,591 (41.1) |
| History of migraine preventives, ever | ||||
| No. of medications, mean (SD) | 2.1 (1.4) | 0.5 (0.8) | 2.8 (1.6) | 1.1 (1.2) |
| Other Anticonvulsants c (%) | 4,870 (45.3) | 3,292 (10.2) | 4,392 (54.1) | 3,042 (16.5) |
| ACEI/ARB (%) d | 262 (2.4) | 324 (1.0) | 3,099 (38.2) | 4,540 (24.6) |
| β-blockers (%) d | 5,034 (46.8) | 4,522 (14.0) | 5,201 (64.0) | 5,844 (31.6) |
| TCAs (%) | 4,625 (43.0) | 4,355 (13.5) | 3,742 (46.1) | 3,023 (16.4) |
| Neurotoxins (%) | 4,485 (41.7) | 761 (2.4) | 3,554 (43.8) | 495 (2.7) |
| Alcohol-related disorder (%) | 1,790 (16.6) | 5,575 (17.3) | 1,868 (23.0) | 4,706 (25.5) |
| Chronic kidney disease (%) | 188 (1.7) | 277 (0.9) | 798 (9.8) | 1,506 (8.1) |
| Diabetes (%) | 594 (5.5) | 1,386 (4.3) | 2,677 (33.0) | 5,854 (31.7) |
| Hyperlipidemia (%) | 3,856 (35.8) | 8,606 (26.7) | 5,926 (73.0) | 12,608 (68.2) |
| Obstructive sleep apnea (%) | 3,532 (32.8) | 7,491 (23.2) | 4,751 (58.5) | 8,788 (47.5) |
| Medications with antihypertensive effect | ||||
| No. of medications, mean (SD) | 1.5 (1.3) | 1.4 (1.3) | ||
| ACEIs/ARBs (%) d | 3,062 (37.7) | 7,334 (39.7) | ||
| α-blockers (%) | 1,232 (15.2) | 2,464 (13.3) | ||
| β-blockers (%) d | 3,094 (38.1) | 5,223 (28.3) | ||
| Calcium channel blockers (%) | 2,198 (27.1) | 4,666 (25.2) | ||
| Centrally acting sympathetic agonist (%) | 181 (2.2) | 324 (1.8) | ||
| Diuretics, potassium-sparing (%) | 398 (4.9) | 752 (4.1) | ||
| Diuretics, thiazide (%) | 1,634 (20.1) | 4,135 (22.4) | ||
| Diuretics, loop (%) | 382 (4.7) | 776 (4.2) | ||
| Nitrates (%) | 171 (2.1) | 401 (2.2) | ||
| Direct renin blocker (%) | 0 (0.0) | 2 (< 0.1) | ||
| Vasodilators (%) | 134 (1.7) | 262 (1.4) | ||
| Follow-up, Median (IQR), y | 1.1 (0.4–2.2) | 0.8 (0.2–1.8) | 1.0 (0.4–2.2) | 0.9 (0.2–2.1) |
| Medication possession ratio, Median (IQR) | 0.89 (0.64–1.00) | 0.83 (0.53–1.00) | 0.92 (0.68–1.00) | 0.89 (0.59–1.00) |
| No. of BP measurements, Median (IQR) | 5.0 (3.0–11.0) | 4.0 (2.0–8.0) | 7.0 (4.0–15.0) | 6.0 (3.0–12.0) |
Abbreviations: SD Standard deviation, BP Blood pressure, IQR Interquartile range
a Gender, race and ethnicity were self-reported from the electronic health record
b Race were self-reported by each person in the administrative dataset and others included Alaska Native or American Indian, Native Hawaiian or other Pacific Islander, and multi-race
c Other Anticonvulsants included lamotrigine, pregabalin and valproates only
d Not mutually exclusive