Inadequate response prediction to acute migraine medication

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Inadequate response prediction to acute migraine medication

Significant consequences of acute migraine therapy include pain freedom at 2 hours and sustained pain response at 24 hours. Although, lesser facts are known about predictors of typical response to acute treatment over multiple attacks in the population, some studies have assessed rates and predictors of successful treatment results in patients with single attack.

Lipton R B et al conducted a study was to assess the sociodemographic features, headache characteristics, comorbidities and treatment-related factors predicting acute treatment success or failure at 2 hours and 24 hours. This was done post dose in a US population sample of persons with episodic migraine.

In this study, eligible respondents completed the survey (2006 American Migraine Prevalence and Prevention Study survey), met criteria for episodic migraine, delineated the use of acute treatment for migraine and answered questions on acute treatment outcomes from the Migraine Treatment Optimization Questionnaire (mTOQ). One question pivoted on 2 hour pain free (2hPF) response and the other focused on pain relief at 2 hours and 24 hours (24hPR). For each question, the responses were regarded as adequate and inadequate, based on the fact if they were achieved “half the time or more” and if they were achieved “never,” “rarely,” or “less than half time.” The models were run to reveal the predictors of outcomes in relation to usual acute treatment: (1) inadequate 2hPF response; (2) inadequate 24hPR response; and (3) inadequate 24 hour Sustained Pain Freedom (24hSPF), which was a conditional inspection of pain freedom at 24 hours among those who initially had an sufficient pain freedom response at 2 hours. For the prediction of each of the 3 outcomes adjusting for covariates, binary logistic regression models were used. Potential predictor variables were analyzed independently and variables that did not cause significantly to outcome prediction were snipped. The retained variables were invaded into a final multivariable binary logistic regression that comprised of age, sex, and the covariates that survived the snipping process. For each variable, the odds ratio (OR) and 95% confidence interval (CI) statistics were generated. A value of P ≤ .05 was used to recognize statistically significant variables.

As per the results, among  8233 eligible respondents with episodic migraine, 56.0% of respondents described inadequate 2hPF response to usual acute treatment and 53.7% reported inadequate 24hPR. Among the 44.0% of individuals who attained adequate 2hPF (N = 3621), 25.7% reported inadequate 24hSPR or recurrence. Demographic variables (male sex and higher body mass index [BMI]), headache features (higher headache pain intensity, cutaneous allodynia, more headache days per month), comorbidity (depression), and migraine pharmacologic treatment factors (not using preventive migraine medications) were all important predictors of Inadequate 2hPF response. As for the siginificant predictors of Inadequate 24hPR- headache features (more headache days per month, higher migraine symptom severity composite score, cutaneous allodynia), comorbidity (depression), and migraine pharmacologic treatment factors (medication overuse) were considered.

It was thus culminated that, there consequences provide a snapshot of the effectiveness of usual acute treatment and predictors of inadequate acute treatment response in a large population sample of people with episodic migraine. The resuts emphasize on the high rates of unmet treatment needs in people with migraine. For resons that are discussed, the similarities and differences in predictors vary with outcome.



Headache. 2016 Oct 12

Link to the source:

Original title of article:

Predicting Inadequate Response to Acute Migraine Medication: Results From the American Migraine Prevalence and Prevention (AMPP) Study


Richard B. Lipton et al.

Headache. 2016 Oct 12
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