Abstract Details

Title Migraine Patients Exhibit Increased Relative Risk for Medication Overuse Headache with Sustained Triptan Treatment – Results from a Real-World Claims Analysis

Topic Headache

Presentation(s) P12 - Poster Session 12 (12:00 PM-1:00 PM)

Poster/Presentation
Number 7-004

Objective The objective of this study was to examine the relationship between triptan exposure and medication overuse headache (MOH).

Background MOH is a debilitating clinical outcome that may derive from currently available treatments for migraine. Triptan use has been associated with MOH but there are no studies describing the magnitude of risk for MOH according to triptan exposure in real-world practice.

Design/Methods The study population was derived from Symphony Health, a managed care database comprising over 250 million lives. The study period was defined from January 1, 2014 to December 31,2018. Patients aged 18 years or older with a diagnosis of migraine by ICD9 (346.x) and ICD-10 (G43.x) were included in the analysis. Cox proportional hazards regression was conducted to derive age-gender adjusted hazard ratios for patients exposed to triptans (by NDC or J-code). The duration of exposure was defined as medication possession ratio (MPR) categories compared to triptan untreated patients. MOH was defined by relevant ICD9-10 (G44.4, 339.3) codes.

Results A total of 7.9 million unique people with migraine were identified with 2.2 million patients exposed to one or more triptans. Age-gender adjusted HRs (95% CI) according to MPR category were reported as follows: MPR (0-0.2): 12.5 (12.1-12.9), N=0.77M; MPR (0.21-0.4): 16.6 (16.0-17.2), N=0.45M; MPR (0.41-0.6): 19.4 (18.7-20.2), N=0.26M; MPR (0.61-0.80): 22.5 (21.5-23.5), N=0.15M; MPR (0.81-1.0): 15.6 (15.1-16.1), N=0.56M. All effects were significant at P<.0001.

Conclusions This large scale real-world claims-based analysis suggests an exposure related trend in MOH risk that exceeds relative effects reported for other risk factors. MOH risk constitutes a significant public health unmet need related to triptan treatment.

Authors/Disclosures
PRESENTER	No disclosure on file
Robert Croop, MD	Dr. Croop has received personal compensation for serving as an employee of Biohaven Pharmaceuticals, Inc. Dr. Croop has received personal compensation for serving as an employee of Pfizer Inc.. Dr. Croop has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Collima LLC. Dr. Croop has stock in Biohaven Pharmaceutical Holding Co Ltd. Dr. Croop has stock in Biohaven Ltd.. Dr. Croop has stock in Actio Biosciences, Inc. . Dr. Croop has received research support from Pfizer Inc. Dr. Croop has received intellectual property interests from a discovery or technology relating to health care. Dr. Croop has received intellectual property interests from a discovery or technology relating to health care.
Vladimir Coric	Vladimir Coric has received personal compensation for serving as an employee of Biohaven. Vladimir Coric has received personal compensation in the range of $1,000,000+ for serving as an officer or member of the Board of Directors for Bioahven. Vladimir Coric has stock in Biohaven. Vladimir Coric has received intellectual property interests from a discovery or technology relating to health care.
Gilbert J. L'Italien	Gilbert J. L'Italien has received personal compensation for serving as an employee of Biohaven Pharmaceuticals. Gilbert J. L'Italien has stock in biohaven pharmaceuticals.
	No disclosure on file
	No disclosure on file

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Abstract Details