OBJECTIVE:The objective of this study was to examine if patients with migraine who responded sufficiently to acute treatment were significantly different from those who did not in terms of patient characteristics, treatment patterns, and patient level of impairment, and to identify characteristics associated with insufficient response.
BACKGROUND:Migraine is highly prevalent and impacts functional ability substantially. Current treatment approaches are not sufficiently meeting the needs of patients, and inadequate response to acute treatment is reported by at least 56% of patients with migraine in the United States.
METHODS:Data were obtained from the 2014 Adelphi Migraine Disease-Specific Program, a cross-sectional survey. Using logistic regression, we assessed the association between patient factors and insufficient response. Responders were defined as patients with migraine who achieved pain freedom within 2 hours of acute treatment in ≥4 of 5 attacks, while insufficient responders achieved it in ≤3 of 5 attacks.
RESULTS:Of 583 patients included, insufficient responders to acute treatment constituted 34.3% (200/583) of the study population. A statistically significantly larger proportion of insufficient responders vs responders had ≥4 migraine headache days/month (46.3% [88/190] vs 31% [114/368]), had ever been prescribed ≥3 unique preventive treatment regimens (11.7% [21/179] vs 6.3% [22/347]), and had chronic migraine, medication-overuse headaches, and comorbid depression (all P values ≤.05). Patient level of impairment was statistically significantly greater among insufficient responders vs responders. Factors associated with insufficient response after adjusting for covariates included Migraine Disability Assessment total score (odds ratio [OR] = 1.04, 95% CI [1.02, 1.05]), time of administration of acute treatment (OR = 1.83, 95% CI [1.15, 2.92]), depression (OR = 1.98, 95% CI [1.21, 3.23]), sensitivity to light not listed as current most troublesome symptom (OR = 2.30, 95% CI [1.21, 4.37]), and change in the average headache days per month before being prescribed an acute treatment vs now (OR = 1.75, 95% CI [1.05, 2.90]).
CONCLUSIONS:Clinical characteristics, treatment patterns, and health-related quality of life measures are statistically significantly different between insufficient responders and responders to acute treatment in patients with migraine.
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【A Real-World Analysis of Patient Characteristics, Treatment Patterns, and Level of Impairment in Patients With Migraine Who are Insufficient Responders vs Responders to Acute Treatment.].
【响应者与急性治疗响应者的偏头痛患者特征，治疗模式和受损程度的真实世界分析。】
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DOI：10.1111/head.13835文章类型：杂志文章
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目的：本研究的目的是检查对急性治疗有充分反应的偏头痛患者在患者特征，治疗模式和患者损伤水平方面是否与未偏头痛患者显着不同，并确定与不足的患者相关的特征回复。
背景：偏头痛非常普遍，并且会严重影响功能能力。当前的治疗方法不能充分满足患者的需求，在美国，至少有56％的偏头痛患者报告对急性治疗的反应不足。
方法：数据来自2014年Adelphi偏头痛疾病专项计划横断面调查。使用逻辑回归，我们评估了患者因素与反应不足之间的关联。响应者被定义为偏头痛患者，在急性发作后2小时内在5次发作中≥4次达到了疼痛自由度，而响应不足的患者在5次发作中≤3次发作中实现了疼痛自由度。
结果：在583例患者中，对急性治疗的反应不足，占研究人群的34.3％（200/583）。统计学上显着更大的反应不足者与反应者相比，≥4个偏头痛天/月（46.3％[88/190] vs 31％[114/368]），曾被处方≥3种独特的预防性治疗方案（11.7％[ [21/179]比6.3％[22/347]），并患有慢性偏头痛，药物滥用性头痛和合并性抑郁症（所有P值均≤.05）。在反应不足者与反应者之间，患者的损伤水平在统计学上显着更大。校正协变量后与反应不足相关的因素包括偏头痛残疾评估总分（赔率[OR] = 1.04，95％CI [1.02，1.05]），急性治疗的给药时间（OR = 1.83，95％CI [1.15] ，2.92]），抑郁（OR = 1.98、95％CI [1.21、3.23]），对光的敏感性未列为当前最麻烦的症状（OR = 2.30，95％CI [1.21、4.37]），并且相对于现在而言，在接受紧急治疗之前每月平均头痛天数（OR = 1.75，95％CI [1.05，2.90]）。
结论：对于偏头痛患者，反应不足和对急性治疗的反应者之间，临床特征，治疗方式和与健康相关的生活质量测量在统计学上有显着差异。
背景：偏头痛非常普遍，并且会严重影响功能能力。当前的治疗方法不能充分满足患者的需求，在美国，至少有56％的偏头痛患者报告对急性治疗的反应不足。
方法：数据来自2014年Adelphi偏头痛疾病专项计划横断面调查。使用逻辑回归，我们评估了患者因素与反应不足之间的关联。响应者被定义为偏头痛患者，在急性发作后2小时内在5次发作中≥4次达到了疼痛自由度，而响应不足的患者在5次发作中≤3次发作中实现了疼痛自由度。
结果：在583例患者中，对急性治疗的反应不足，占研究人群的34.3％（200/583）。统计学上显着更大的反应不足者与反应者相比，≥4个偏头痛天/月（46.3％[88/190] vs 31％[114/368]），曾被处方≥3种独特的预防性治疗方案（11.7％[ [21/179]比6.3％[22/347]），并患有慢性偏头痛，药物滥用性头痛和合并性抑郁症（所有P值均≤.05）。在反应不足者与反应者之间，患者的损伤水平在统计学上显着更大。校正协变量后与反应不足相关的因素包括偏头痛残疾评估总分（赔率[OR] = 1.04，95％CI [1.02，1.05]），急性治疗的给药时间（OR = 1.83，95％CI [1.15] ，2.92]），抑郁（OR = 1.98、95％CI [1.21、3.23]），对光的敏感性未列为当前最麻烦的症状（OR = 2.30，95％CI [1.21、4.37]），并且相对于现在而言，在接受紧急治疗之前每月平均头痛天数（OR = 1.75，95％CI [1.05，2.90]）。
结论：对于偏头痛患者，反应不足和对急性治疗的反应者之间，临床特征，治疗方式和与健康相关的生活质量测量在统计学上有显着差异。
