To assess interictal burden (IIB) before patients initiate their first calcitonin gene-related peptide (CGRP) monoclonal antibody (mAb) for migraine prevention.

Migraine is characterized by disabling attacks, but the factors that occur within headache-free intervals may have a profound impact on well-being and are a key driver for treatment seeking behavior. Hence, understanding IIB in patients with migraine is important.

We conducted a 20–30-minute, non-interventional, cross-sectional, online survey in the US among 500 patients who recently enrolled in the galcanezumab Patient Support Program between Jul-Dec 2022. Patients were ≥18 years of age, diagnosed with episodic (EM, n = 250) or chronic (CM, n =250) migraine, and had initiated galcanezumab ≤6 months prior to survey completion/were naïve to galcanezumab. IIB was estimated using the Migraine IIB Scale (MIBS-4) total score (0=no burden, 1–2=mild, 3–4=moderate, 5–12=severe). Patients were asked to recall the time before starting galcanezumab and answer bespoke survey questions such as worries about missing/cancelling upcoming social obligations because of migraine attacks or impact of migraine on job/school, hobbies and exercise. All analyses were descriptive.

Overall, mean time since first migraine symptom was 18.1 years. Anxiety (45%) and depression (44%) were the most prevalent comorbidities. Mean (SD) MIBS-4 total score was 4.3 (3.2) (EM:3.8 [3.0], CM:4.8 [3.4]) suggesting moderate to severe burden. MIBS-4 results indicated approximately half (46%; EM:40%, CM:53%) of the patients had severe IIB, while the rest had moderate (19%; EM:21%, CM:17%), mild (19%; EM:22%, CM:16%), or no (16%; EM:18%, CM: 14%) IIB. Most patients (71%; EM:64%, CM:79%) often/always had less energy for work/school during the headache-free intervals and most (70%; EM:64%, CM:76%) often/always worried about the impact of migraine on work/school.

Patients with migraine, particularly those with chronic migraine, experience moderate to severe interictal burden before initiating galcanezumab as their first CGRP mAb.