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. 2024 Sep 12;25(1):150.
doi: 10.1186/s10194-024-01859-3.

Filling the data gap on CGRP mAb therapy in low- to middle-income countries in Southeast Asia: insights from a real-world study in Thailand

Prakit Anukoolwittaya  1   2   3   4 , Akarin Hiransuthikul  1   5 , Thanakit Pongpitakmetha  6   7   8   9   10 , Sekh Thanprasertsuk  1   2   3   4   11   12 , Wanakorn Rattanawong  1   4   13
Affiliations

Filling the data gap on CGRP mAb therapy in low- to middle-income countries in Southeast Asia: insights from a real-world study in Thailand

Prakit Anukoolwittaya et al. J Headache Pain. .

Erratum in

Abstract

Background: Most real-world data on CGRP mAbs have been published from high-income countries such as the USA, Western countries, Japan, Korea, and Singapore. However, data from low- and middle-income countries in Southeast Asia is lacking. This is the first real-world study from Thailand to describe the efficacy of CGRP mAbs therapy in migraine patients and to analyze the response trends between episodic migraine and chronic migraine.

Methods: We conducted a single-center, real-world retrospective chart review study with an observation period of 6 months after CGRP mAbs initiation. We aim to compare treatment responses to CGRP mAbs between EM and CM patients.

Results: A total of 47 Thai patients were enrolled (median [IQR] age 37.2 [28.6-50.4] years; 85.1%F, 44.7% EM; 70.2% galcanezumab). There was no difference in baseline characteristics and migraine disability assessment (MIDAS) between EM and CM. The overall ≥ 30%, ≥ 50%, and ≥ 70% monthly migraine day reduction rates at 6 months were 89.0%, 71.6%, and 58.5% with higher responders in EM. There was a significant decrease in monthly headache days (MHDs) over time (adjusted β = -0.42, p < 0.001) and a significant decrease in MIDAS score over time after the initiation of CGRP mAbs (adjusted β = -1.12, p = 0.003). However, there were no differences between the two diagnoses. There was no significant decrease in the number of abortive medication pills used over time after the initiation of CGRP mAbs. CM had a significantly steeper trend compared to those with EM.

Conclusion: The first real-world study in Thailand demonstrated that CGRP mAbs therapy had efficacy for migraine treatment, as evidenced by a reduction in MHDs, decreased disability, and reduced use of abortive medications. Additionally, the response pattern to CGRP mAbs therapy was similar between EM and CM in terms of MHDs reduction and MIDAS score improvement.

Keywords: CGRP mAbs; Low-middle-income counties; Migraine; Real-world data; Thailand; Treatment response.

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Conflict of interest statement

Authors report no significant conflict of interest related to this topic.

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Kaplan-Meier plots showing the proportion of responders among overall migraine patients (green line), episodic migraine patients (blue line), and chronic migraine patients (orange line) over the observation periods (6 months): (A) ≥ 30% responder rate, (B) ≥ 50% responder rate, and (C) ≥ 75% responder rate
Fig. 2
Fig. 2
Changes in monthly headache days in episodic migraine (EM) (A) and chronic migraine (CM) (B) from baseline to six months after CGRP mAbs treatment
Fig. 3
Fig. 3
Changes in monthly headache days in relation to baseline in episodic migraine (EM) (A) and chronic migraine (CM) (B) from baseline to six months after CGRP mAbs treatment
Fig. 4
Fig. 4
Changes in MIDAS score in episodic migraine (EM) (A) and chronic migraine (CM) (B) from baseline to six months after CGRP mAbs treatment
Fig. 5
Fig. 5
Changes in MIDAS score in relation to baseline in episodic migraine (EM) (A) and chronic migraine (CM) (B) from baseline to six months after CGRP mAbs treatment
Fig. 6
Fig. 6
Changes in the number of abortive medication pill used in episodic migraine (EM) (A) and chronic migraine (CM) (B) from baseline to six months after CGRP mAbs treatment
Fig. 7
Fig. 7
Changes in the number of acute abortive pill used in relation to baseline in episodic migraine (EM) (A) and chronic migraine (CM) (B) from baseline to six months after CGRP mAbs treatment
See this image and copyright information in PMC

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