Abstract Details

Title Reduction in Period Prevalence of Medication Overuse Headache Following Initiation of Nurtec ODT Treatment – A Real World Administrative Claims Study

Topic Headache

Presentation(s) P12 - Poster Session 12 (5:30 PM-6:30 PM)

Poster/Presentation
Number 15-003

Background There are nearly 40 million migraine patients in the US. Certain analgesics and front-line abortive medicines, like triptans, are associated with an increase in the risk of MOH, which is believed to affect up to 2% of the general population. We posited that treatment with Nurtec ODT, a novel CGRP antagonist, might reduce the rate of MOH among patients previously treated with triptans.

Objective To describe the period prevalence of medication overuse headache (MOH) among migraine patients before and after initiation of Nurtec ODT therapy.

Design/Methods The study population was derived from a large longitudinal integrated medical and pharmacy commercial claims database. Claims for 280,773 Nurtec ODT patients were examined between 6/15/2019 and 7/31/2021. To be included, patients were required to have 6, 12, or 18 months of total follow-up. Three observation periods were defined: 3, 6, and 9 months pre/post Nurtec ODT Initiation (NI). A prior triptan fill was observed for 64.7% of Nurtec ODT patients. Patients were required to have a minimum of 2 Nurtec dispensings within the post NI period. Period prevalence (PP) of ICD-10 MOH was assessed for each pre/post NI period and compared. The method assured that the same patients were assessed pre/post NI, thus rendering each patient as internal ‘control’.

Results Among 119,396 patients, MOH PP decreased from 0.44%+0.03% to 0.13%+0.02% (-70%, p<0.00001) in the 3-month period. Among 81,683 patients, MOH PP decreased from 0.57%+0.04% to 0.21%+0.03% (-63%, p<0.00001) in the 6-month period. Among 60,960 patients, MOH PP decreased from 0.75%+0.06% to 0.26%+0.07% (-65%, p<0.00001) in the 9-month period.

Conclusions This unique real-world analysis demonstrates that treatment with Nurtec ODT is associated with clinically significant improvements in the burden of MOH, expressed as period prevalence within 3 months of its initiation.

Authors/Disclosures
Ali Mohajer, PhD (Qral Group) PRESENTER	Dr. Mohajer has received personal compensation for serving as an employee of Qral Group, LLC.
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.
Linda Harris, MPH (Biohaven Pharmaceuticals)	Ms. Harris has received personal compensation for serving as an employee of Biohaven Pharmaceuticals. Ms. Harris has received stock or an ownership interest from Biohaven Pharmaceuticals.
	No disclosure on file
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.
Noah Rosen, MD, FAAN	Dr. Rosen has received personal compensation for serving as an employee of Northwell Health. An immediate family member of Dr. Rosen has received personal compensation for serving as an employee of New York University. Dr. Rosen has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Allergan/ Abbvie. Dr. Rosen has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Eli Lilly. Dr. Rosen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Lundbeck. Dr. Rosen has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Pfizer . Dr. Rosen has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Allergan/ Abbvie. Dr. Rosen has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Springer. Dr. Rosen has received personal compensation in the range of $500-$4,999 for serving as a Speaker with American Headache Society.