Abstract Details

Title Do Migraine Patients with Obesity Receive Different Treatments? Insights from Real-World Data

Topic Headache

Presentation(s) P9 - Poster Session 9 (5:00 PM-6:00 PM)

Poster/Presentation
Number 15-006

Objective The aim of this study was to evaluate differences in acute and chronic migraine medication prescriptions between patients with and without obesity.

Background Patients with obesity often experience stigma in healthcare, which may lead to underdiagnosis or undertreatment. In the context of pain management, and migraine specifically, patients with obesity are more likely to receive both opioid and non-opioid analgesics. However, little is known about their use of preventive treatments.

Design/Methods We conducted a large retrospective cohort study using propensity score matching for sex and age, utilizing data from the Clalit Health Services database in Israel. The study compared newly diagnosed migraine patients with and without obesity, identified between June 2020 and June 2023. The comparison focused on prescriptions for migraine-specific acute medication (triptans) and preventive migraine treatments.

Results

Our final analysis included 11,934 patients with migraine and obesity and 11,934 without obesity. Patients with obesity were more likely to have cardiovascular risk factors and psychiatric comorbidities. Patients with obesity were also more likely to receive acute treatment with triptans (adjusted Odds Ration [aOR] 1.17, 95% CI [1.11–1.23]), and preventive treatments such as topiramate (aOR 1.66, 95% CI [1.38–1.99]), gabapentinoids (aOR 1.30, 95% CI [1.13–1.50]), and duloxetine (aOR 1.42, 95% CI [1.18–1.70]), adjusting for comorbidities.

Conclusions Our findings do not support the notion that patient with migraine and obesity are undertreated; instead, they show a modest increase in prescriptions for acute and some of the preventive medications.

Authors/Disclosures
Keshet Pardo, MD PRESENTER	Dr. Pardo has nothing to disclose.
Maor Mermelstein, MD	Dr. Mermelstein has received personal compensation in the range of $500-$4,999 for serving as a One time honoraria for a lecture on migraines for primary physicians with Novartis.
Gal Tsur, MD	Dr. Tsur has nothing to disclose.
Shlomit Yust-Katz, MD	Dr. Yust-Katz has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for pfizer. Dr. Yust-Katz has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Organon. Dr. Yust-Katz has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Pfizer. The institution of Dr. Yust-Katz has received research support from MERK.

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