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“I think the most important thing is to understand what the patient is feeling. Even on your busy days, when you’re seeing 30 patients and you think, ‘I don’t have time for this,’ take a deep breath in those moments, realize that a lot of the anger comes from the patient’s frustration with the progression of their disease, and communicate that to the patient.”
Migraine is one of the most disabling neurological disorders worldwide, and patients often experience significant impairment in daily activities and quality of life.1 Furthermore, migraine sufferers, who are difficult to treat, often undergo repeated cycles of different preventive therapies. In a cross-sectional analysis recently published in The Journal of Headache and Pain, researchers observed increased burden, reduced quality of life, and functional impairment in migraine patients who experienced at least four headache days per month and had a higher incidence of treatment failures.2 These results, despite the inability to determine cause and direction, suggest the need for effective preventive migraine treatments.
DELIVER is a multicenter, randomized, parallel-group, double-blind, placebo-controlled trial (NCT04418765) evaluating eptinezumab (Vyepti, Lundbeck) as a preventive treatment for patients who have failed two to four prior preventive migraine treatments. A recent analysis of the trial found that clinical response to eptinezumab was maintained in most patients who reported at least a 50% migraine response after one or two treatments. Among patients who had at least a 50% response to the first dose, 61% and 74% maintained at least a 50% response to eptinezumab 100 mg (n = 113) and eptinezumab 300 mg (n = 126), respectively, through 18 months. Among patients who responded to the first two doses of eptinezumab, the percentage of patients who maintained a 50% response state for the remaining four doses was 69% (100 mg, n = 128) and 82% (300 mg, n = 131), respectively.3
Lead author Jessica Ailani, MD, PhD, director of MedStar Georgetown Headache Center, presented these recent findings at the 2024 American Academy of Neurology (AAN) Annual Meeting, held April 13-18 in Denver, Colorado. Ailani spoke with NeurologyLive® at the meeting to discuss how data analytics can help shape treatment approaches for migraine patients. She also discussed strategies clinicians can employ to effectively address patient frustration and maintain hope throughout the treatment journey. Ailani also discussed how the health care system can better support migraine patients who experience disappointment or a sense of failure in their treatment attempts.
For more information on AAN 2024, click here.
References
1. Pozo-Rosich P, Lucas C, Watson DPB, et al. “Burden of migraine in patients with preventive treatment failure attending European headache specialist centres: real-world evidence from the BECOME study.” Pain Ther. 2021;10(2):1691-1708. doi:10.1007/s40122-021-00331-3
2. Buse DC, Pozo-Rosich P, Dupont-Benjamin L, et al. “Impact of headache frequency and preventive medication failure on quality of life, function, and costs among migraineurs in several European countries: the need for effective preventive treatments.” J Headache Pain. 2023;24(1):115. Published August 24, 2023. doi:10.1186/s10194-023-01655-5
3. Ailani J, Soni-Brahmbhatt S, Awad S, et al. “Long-term maintenance of ≥50% migraine response with eptinezumab treatment in patients who have failed 2-4 prior preventive migraine treatments.” Presented at: 2024 AAN Annual Meeting, April 13-18, Denver, Colorado.
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