COMPARING THE DISEASE BURDEN OF MIGRAINE BETWEEN USERS OF CGRP MONOCLONAL ANTIBODIES AND PREVENTIVE GEPANTS
Author(s)
Neelanzana Paudel, MS, Nemin Chen, PhD, Vicky W. Li, MPH;
Oracle Life Sciences, Austin, TX, USA
Oracle Life Sciences, Austin, TX, USA
OBJECTIVES: This research examines sociodemographic characteristics and clinical burden among users of calcitonin gene related peptide monoclonal antibodies (CGRP mAbs) and preventive gepants.
METHODS: Data from the 2025 US National Health and Wellness Survey, a cross-sectional online survey of the general US adult population, was used. Analysis included participants that: (1) Experienced migraine or migraine headaches in the past 12 months; (2) Physician diagnosis of migraine; and (3) Currently using CGRP mAbs (erenumab, fremanezumab, eptinezumab, or galcanexumab) or preventive gepants (rimegepant or atogepant). Study variables included sociodemographic and clinical characteristics, and migraine-specific measures (Migraine Disability Assessment [MIDAS] and the Migraine Treatment Optimization Questionnaire [mTOQ-6]). Psychological burden was evaluated using PHQ-9 and GAD-7 scales for symptoms of depression and anxiety.
RESULTS: A total of 857 participants were included (preventive gepants: n=257; CGRP mAbs: n=600). CGRP mAbs users were younger (43.6 vs. 50.1 years), more males (65.8% vs. 19.1%), more smokers (60.0% vs. 16.0%), had more comorbidities, and had higher income and education levels than preventive gepant users (all p<0.001). Despite reporting fewer mean migraines (5.2 vs. 6.3; p=0.048) and headache days (7.0 vs. 9.1; p=0.003) in the past 30 days, CGRP mAbs users were more likely to have MIDAS Grade IV disability (40.8% vs. 36.6%; p=0.012) and lower mTOQ-6 scores (18.7 vs. 20.1; p<0.001) compared with preventive gepant users, as well as experience more depression and anxiety symptoms (PHQ-9 scores: 12.1 vs. 7.2; p<0.001; GAD-7 scores: 9.4 vs. 6.6; p<0.001).
CONCLUSIONS: In a national survey of general US adults, CGRP mAbs users reported fewer migraines and headache days than those on preventive gepants (though still greater than the meaningful clinical goal of ≤4 days per month), but experienced lower treatment efficacy, greater mental health burden and migraine-related disability. These findings underscore the need to address psychological and functional burden among patients on migraine preventives.
METHODS: Data from the 2025 US National Health and Wellness Survey, a cross-sectional online survey of the general US adult population, was used. Analysis included participants that: (1) Experienced migraine or migraine headaches in the past 12 months; (2) Physician diagnosis of migraine; and (3) Currently using CGRP mAbs (erenumab, fremanezumab, eptinezumab, or galcanexumab) or preventive gepants (rimegepant or atogepant). Study variables included sociodemographic and clinical characteristics, and migraine-specific measures (Migraine Disability Assessment [MIDAS] and the Migraine Treatment Optimization Questionnaire [mTOQ-6]). Psychological burden was evaluated using PHQ-9 and GAD-7 scales for symptoms of depression and anxiety.
RESULTS: A total of 857 participants were included (preventive gepants: n=257; CGRP mAbs: n=600). CGRP mAbs users were younger (43.6 vs. 50.1 years), more males (65.8% vs. 19.1%), more smokers (60.0% vs. 16.0%), had more comorbidities, and had higher income and education levels than preventive gepant users (all p<0.001). Despite reporting fewer mean migraines (5.2 vs. 6.3; p=0.048) and headache days (7.0 vs. 9.1; p=0.003) in the past 30 days, CGRP mAbs users were more likely to have MIDAS Grade IV disability (40.8% vs. 36.6%; p=0.012) and lower mTOQ-6 scores (18.7 vs. 20.1; p<0.001) compared with preventive gepant users, as well as experience more depression and anxiety symptoms (PHQ-9 scores: 12.1 vs. 7.2; p<0.001; GAD-7 scores: 9.4 vs. 6.6; p<0.001).
CONCLUSIONS: In a national survey of general US adults, CGRP mAbs users reported fewer migraines and headache days than those on preventive gepants (though still greater than the meaningful clinical goal of ≤4 days per month), but experienced lower treatment efficacy, greater mental health burden and migraine-related disability. These findings underscore the need to address psychological and functional burden among patients on migraine preventives.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
PCR91
Topic
Patient-Centered Research
Topic Subcategory
Patient Engagement, Patient-reported Outcomes & Quality of Life Outcomes
Disease
SDC: Neurological Disorders