To compare HRQoL of patients who are triptan insufficient responders versus responders based on real-world data.

This cross-sectional cohort study used US data from the Adelphi Migraine Disease Specific Programme™ from 2017. Triptan insufficient responders were defined as currently prescribed or having received a triptan in the past 6 months and failing to achieve pain freedom at 2 hours post dose on >half of occasions, or having responded to a triptan in the past but having discontinued because of inefficacy or adverse events, as determined by the physician. Outcomes included responses to MIDAS, MSQ v2.1, and WPAI-Migraine questionnaires.

This analysis utilized US data from the Adelphi Disease-Specific Programme™, a multi-country, cross-sectional study using data from electronic medical records (EMR), and patient and physician surveys collected from August to December 2017. TIRs were defined as patients currently prescribed triptans/had received triptans in the past 6 months and failed to achieve pain freedom at 2 hours post dose, or responded to triptans but discontinued due to lack of efficacy or side effects. Outcomes included opioid use, hospital admissions (inpatient/emergency room), and healthcare professional (HCP) visits extracted from EMR, and self-reported rebound headache. Logistic and Poisson regression models were used to compare each outcome between triptan insufficient responders and responders, adjusting for demographics, migraine type, frequency, and severity.

Of 1373 patients, 39.0% were triptan responders and 24.4% were insufficient responders. The remaining 502 patients were not categorized because of unknown/no history of triptan use. On the MIDAS, triptan insufficient responders versus responders reported significantly (P<0.05) higher rates of mild (23% versus 14%, respectively), moderate (17% versus 10%), and severe disability (19% versus 6%). Triptan insufficient responders had a significantly (P<0.05) reduced HRQoL than responders across all 3 MSQ v2.1 domains (lower scores indicated reduced quality of life) (Role Function: Restrictive, 63 versus 75, respectively; Role Function: Preventive, 74 versus 82; and Emotional Function, 71 versus 81). The percentage of time affected by overall work and activity impairment was higher for triptan insufficient responders (35% and 36%, respectively) than responders (25% and 26%, respectively; P<0.05).

There remains an unmet treatment need for patients with an insufficient response to currently available acute treatments for migraine attacks. The associated impact on disability and work and activity impairment suggests a need for better management of patients who do not respond to or discontinue triptans because of inefficacy or adverse events.