# Continuation, Resumption, and Withdrawal Rates of CGRP-mAb Treatment for Migraine Under Real-World Clinical Conditions in Which Patients Are Free to Choose Own Treatment

## TL;DR

This study examines how often patients continue, restart, or stop using CGRP-mAb injections for migraine in real-world settings where they choose their treatment.

## Contribution

The study provides real-world data on treatment adherence and resumption rates of CGRP-mAb therapy for migraine patients.

## Key findings

- The continuation rate of CGRP-mAb treatment was 58.8% at 12 months and 51.7% at 24 months.
- The resumption rate for patients who discontinued was 76.8%, and the withdrawal rate was 20.7%.
- HIT-6 and MSQ scores significantly improved after treatment initiation.

## Abstract

Background/Objectives: Anti-calcitonin gene-related peptide monoclonal antibodies (CGRP-mAbs) are effective injectable medications for the treatment of migraine. This study aimed to evaluate continuation, resumption, and withdrawal rates of CGRP-mAb treatment under real-world clinical conditions. Methods: Treatment-naïve patients with at least 3 months of follow-up after starting CGRP-mAb treatment were included. The decision to continue, discontinue, or resume CGRP-mAb treatment was made freely by the patients. Headache Impact Test-6 (HIT-6) and the Migraine-Specific Quality of Life Questionnaire (MSQ) were administered before starting treatment and one month after each CGRP-mAb injection. The endpoints were as follows: continuation rates of CGRP-mAb treatment after treatment initiation; resumption rate; withdrawal rate; changes in HIT-6 and MSQ scores; and differences in background factors between the resumption and withdrawal groups. Results: Of the 1162 migraine patients, 146 were included in the analysis. Continuation rates of CGRP-mAb treatment at 3, 6, 9, 12, 18, and 24 months were 93.2%, 80.2%, 68.9%, 58.8%, 55.4%, and 51.7%, respectively. For the patients who discontinued, the resumption rate was 76.8%, and the withdrawal rate was 20.7%. HIT-6 and MSQ scores were significantly decreased at all assessment points compared with before CGRP-mAb treatment. There were no significant differences in factors between the resumption and withdrawal groups. Conclusions: Under real-world clinical conditions in which patients were free to choose their own treatment, the continuation rate of CGRP-mAb treatment 12 months after treatment initiation was 58.8%, and more than half of patients remained on treatment after 24 months. The resumption rate was 76.8% and the withdrawal rate was 20.7%.