Table 3.
Medications used during 12-month baseline and follow-up period
| 12-month baseline | 12-month follow-up | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Galcanezumab, n=2674 | Fremanezumab, n=2674 | Fremanezumab vs galcanezumab, p-value | Galcanezumab, n=3503 | Erenumab, n=3503 | Erenumab vs galcanezumab, p-value | Galcanezumab, n=2674 | Fremanezumab, n=2674 | Fremanezumab vs galcanezumab, p-value | Galcanezumab, n=3503 | Erenumab, n=3503 | Erenumab vs galcanezumab, p-value | |
| Any acute migraine treatment (n, %) | ||||||||||||
| Established efficacy | ||||||||||||
| Triptans | 1822, 68.1% | 1782, 66.6% | 0.243 | 2385, 68.1% | 2372, 67.7% | 0.739 | 1570, 58.7% | 1536, 57.4% | 0.346 | 2053, 58.6% | 2082, 59.4% | 0.481 |
| Ergotamine derivatives | 5, 0.2% | 11, 0.4% | 0.098 | 6, 0.2% | 12, 0.3% | 0.157 | 4, 0.2% | 3, 0.1% | 1 | 7, 0.2% | 11, 0.3% | 0.345 |
| Gepantsa | 31, 1.1% | 38, 1.4% | 0.362 | 46, 1.3% | 27, 0.8% | 0.025 | 253, 9.5% | 315, 11.8% | 0.006 | 340, 9.7% | 332, 9.5% | 0.746 |
| Lasmiditan | 2, 0.1% | 1 | 1 | 3, 0.1% | 1 | 0.625 | 17, 0.6% | 15, 0.6% | 0.723 | 23, 0.7% | 15, 0.4 | 0.193 |
| Nonopioid analgesics and combinationsb | 1715, 64.1% | 1662, 62.2% | 0.133 | 2244, 64.1% | 2210, 63.1% | 0.399 | 1488, 55.7% | 1536, 57.4% | 0.185 | 1954, 55.8% | 1995, 57% | 0.323 |
| NSAIDs | 1427, 53.4% | 1377, 51.5% | 0.171 | 1862, 53.2% | 1817, 51.9% | 0.282 | 1208, 45.2% | 1242, 46.5% | 0.344 | 1583, 45.2% | 1625, 46.4% | 0.314 |
| Isometheptene-containing compounds | 17, 0.6% | 6, 0.2% | 0.027 | 22, 0.6% | 14, 0.4% | 0.181 | 1 | 1 | — | 1 | 3, 0.1% | 0.625 |
| Barbiturates (butalbital-containing combinations)#,* | 508, 19% | 489, 18.3% | 0.505 | 663, 18.9% | 639, 18.2% | 0.461 | 361, 13.5% | 357, 13.4% | 0.888 | 475, 13.6% | 500, 14.3% | 0.388 |
| Opioidsc,^ | 1241, 46.4% | 1300, 48.6% | 0.103 | 1624, 46.4% | 1652, 47.2% | 0.503 | 1159, 43.3% | 1242, 46.5% | 0.022 | 1523, 43.5% | 1584, 45.2% | 0.142 |
| Probably effective | ||||||||||||
| Other forms of dihydroergotamine | 59, 2.2% | 50, 1.9% | 0.410 | 76, 2.2% | 68, 1.9% | 0.501 | 55, 2% | 43, 1.6% | 0.240 | 68, 1.9% | 73, 2.1% | 0.671 |
| Antiemetics | 877, 32.8% | 886, 33.1% | 0.793 | 1149, 32.8% | 1120, 32% | 0.459 | 723, 27% | 724, 27.1% | 0.975 | 948, 27.1% | 967, 27.6% | 0.611 |
| Magnesium, IV | 56, 2.1% | 57, 2.1% | 0.886 | 77, 2.2% | 75, 2.1% | 0.870 | 54, 2% | 43, 1.6% | 0.260 | 70, 2% | 75, 2.1% | 0.675 |
| Any preventive migraine treatment (n, %) | ||||||||||||
| Established efficacy | ||||||||||||
| Candesartan | 19, 0.7% | 13, 0.5% | 0.326 | 26, 0.7% | 29, 0.8% | 0.685 | 22, 0.8% | 8, 0.3% | 0.013 | 28, 0.8% | 38, 1.1% | 0.216 |
| Onabotulinumtoxin A | 457, 17.1% | 399, 14.9% | 0.031 | 598, 17.1% | 458, 13.1% | <0.001 | 440, 16.4% | 386, 14.4% | 0.043 | 571, 16.3% | 459, 13.1% | 0 |
| Antiepileptic drugs | 1094, 40.9% | 1066, 39.9% | 0.435 | 1426, 40.7% | 1415, 40.4% | 0.789 | 723, 27% | 708, 26.5% | 0.654 | 938, 26.8% | 901, 25.7% | 0.315 |
| β-blockers | 577, 21.6% | 589, 22% | 0.691 | 767, 21.9% | 781, 22.3% | 0.687 | 466, 17.4% | 503, 18.8% | 0.183 | 621, 17.7% | 624, 17.8% | 0.925 |
| Probably effective | ||||||||||||
| Antidepressants | 635, 23.8% | 634, 23.7% | 0.974 | 847, 24.2% | 836, 23.9% | 0.758 | 504, 18.8% | 512, 19.2% | 0.767 | 666, 19% | 675, 19.3% | 0.785 |
| Memantine | 18, 0.7% | 31, 1.2% | 0.062 | 23, 0.7% | 33, 0.9% | 0.180 | 25, 0.9% | 37, 1.4% | 0.109 | 32, 0.9% | 27, 0.8% | 0.513 |
| Lisinopril | 144, 5.4% | 134, 5% | 0.558 | 184, 5.3% | 176, 5% | 0.665 | 157, 5.9% | 150, 5.6% | 0.702 | 205, 5.9% | 202, 5.8% | 0.878 |
| β-blockers | 99, 3.7% | 98, 3.7% | 0.971 | 130, 3.7% | 130, 3.7% | 1 | 84, 3.1% | 87, 3.3% | 0.816 | 107, 3.1% | 102, 2.9% | 0.725 |
Notes: The following medications were included within each drug class. Gepants — ubrogepant, rimegepant; NSAIDs — aspirin, celecoxib oral solution, diclofenac, ibuprofen, naproxen, flurbiprofen, ketoprofen, ketorolac, IV and IM; antiemetics —droperidol, chlorpromazine, metoclopramide, prochlorperazine, promethazine; antiepileptic drugs — divalproex sodium, sodium valproate, topiramate; β-blockers — metoprolol, propranolol, timolol (established efficacy), atenolol, nadolol (probably effective); antidepressants — amitriptyline, venlafaxine. aAtogepant use was also examined, but no claims were found for any of the study participants. Atogepant was FDA-approved on September 28, 2021, 2 days before the end of the present study period. bIn addition to NSAIDS, isometheptene-containing compounds, and barbiturates, this category also contained other nonopioid analgesics: acetaminophen, phenylbutazone, bromfenac sodium, salicylates, meloxicam, clonidine, diflunisal, etodolac, fenoprofen, indomethacin, meclofenamate, mefenamic acid, nabumetone, nepafenac, oxaprozin, oxyphenbutazone, piroxicam, rofecoxib, sulindac, suprofen, tolmentin, valdecoxib, and ziconotide acetate. cBuprenorphine, butorphanol, codeine, dezocine, fentanyl, hydrocodone, hydromorphone, levomethadyl, levorphanol, meperidine, methadone, morphine, nalbuphine, oxycodone, oxymorphone, pentazocine, propoxyphene, tapentadol, tramadol, and combinations. #Bigal ME and Lipton RB. Neurology. 2008;71(22):1821–1828.17 *Silberstein S et al. Cephalalgia. 2005. 25(6):460–465.18 ^AHS Consensus Statement. Headache. 2018. doi: 10.1111/head.13456.10