Evaluating the clinical utility of the patient-identified most bothersome symptom measure from PROMISE-2 for research in migraine prevention.

chronic migraine eptinezumab most bothersome symptom patient-identified most bothersome symptom

Journal

Headache
ISSN: 1526-4610
Titre abrégé: Headache
Pays: United States
ID NLM: 2985091R

Informations de publication

Date de publication:
06 2022
Historique:
revised: 08 03 2022
received: 09 11 2021
accepted: 08 03 2022
pubmed: 26 4 2022
medline: 24 6 2022
entrez: 25 4 2022
Statut: ppublish

Résumé

To assess the utility of the novel patient-identified (PI) most bothersome symptom (MBS) measure from PROMISE-2, a phase 3 trial of eptinezumab for the preventive treatment of chronic migraine. Relief of bothersome migraine symptoms can influence satisfaction with treatment and therapeutic persistence. Understanding the impact of preventive treatment on a PI-MBS could improve clinical decision-making. In PROMISE-2, patients with chronic migraine received eptinezumab 100, 300 mg, or placebo administered intravenously every 12 weeks for up to 2 doses (n = 1072). PI-MBS was an exploratory outcome requiring each patient to self-report their MBS in response to an open-ended question. At baseline and week 12, patients rated overall improvement in PI-MBS. The relationships among PI-MBS at week 12 and change in monthly migraine days (MMDs) from baseline to month 3 (weeks 9-12), Patient Global Impression of Change at week 12, and changes from baseline to week 12 in the 6-item Headache Impact Test total, EuroQol 5-dimensions 5-levels visual analog scale, and 36-item Short-Form Health Survey component scores were assessed. Treatment groups had similar baseline characteristics and reported a total of 23 unique PI-MBS, most commonly light sensitivity (200/1072, 18.7%), nausea/vomiting (162/1072, 15.1%), and pain with activity (147/1072, 13.7%). Improvements in PI-MBS at week 12 correlated with changes in MMDs (ρ = -0.49; p < 0.0001) and other patient-reported outcomes. Controlling for changes in MMDs, PI-MBS improvement predicted other patient-reported outcomes in expected directions. The magnitude of the standardized mean differences between placebo and active treatment for PI-MBS were 0.31 (p < 0.0001 vs. placebo) and 0.54 (p < 0.0001 vs. placebo) for eptinezumab 100 and 300 mg, respectively. Improvement in PI-MBS at week 12 was associated with improvement in other patient-reported outcome measures, and PI-MBS may be an important patient-centered measure of treatment benefits in patients with chronic migraine.

Sections du résumé

OBJECTIVE
To assess the utility of the novel patient-identified (PI) most bothersome symptom (MBS) measure from PROMISE-2, a phase 3 trial of eptinezumab for the preventive treatment of chronic migraine.
BACKGROUND
Relief of bothersome migraine symptoms can influence satisfaction with treatment and therapeutic persistence. Understanding the impact of preventive treatment on a PI-MBS could improve clinical decision-making.
METHODS
In PROMISE-2, patients with chronic migraine received eptinezumab 100, 300 mg, or placebo administered intravenously every 12 weeks for up to 2 doses (n = 1072). PI-MBS was an exploratory outcome requiring each patient to self-report their MBS in response to an open-ended question. At baseline and week 12, patients rated overall improvement in PI-MBS. The relationships among PI-MBS at week 12 and change in monthly migraine days (MMDs) from baseline to month 3 (weeks 9-12), Patient Global Impression of Change at week 12, and changes from baseline to week 12 in the 6-item Headache Impact Test total, EuroQol 5-dimensions 5-levels visual analog scale, and 36-item Short-Form Health Survey component scores were assessed.
RESULTS
Treatment groups had similar baseline characteristics and reported a total of 23 unique PI-MBS, most commonly light sensitivity (200/1072, 18.7%), nausea/vomiting (162/1072, 15.1%), and pain with activity (147/1072, 13.7%). Improvements in PI-MBS at week 12 correlated with changes in MMDs (ρ = -0.49; p < 0.0001) and other patient-reported outcomes. Controlling for changes in MMDs, PI-MBS improvement predicted other patient-reported outcomes in expected directions. The magnitude of the standardized mean differences between placebo and active treatment for PI-MBS were 0.31 (p < 0.0001 vs. placebo) and 0.54 (p < 0.0001 vs. placebo) for eptinezumab 100 and 300 mg, respectively.
CONCLUSIONS
Improvement in PI-MBS at week 12 was associated with improvement in other patient-reported outcome measures, and PI-MBS may be an important patient-centered measure of treatment benefits in patients with chronic migraine.

Identifiants

pubmed: 35466430
doi: 10.1111/head.14295
pmc: PMC9325355
doi:

Types de publication

Clinical Trial, Phase III Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

690-699

Informations de copyright

© 2022 The Authors. Headache: The Journal of Head and Face Pain published by Wiley Periodicals LLC on behalf of American Headache Society.

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Auteurs

Richard B Lipton (RB)

Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, USA.

Peter J Goadsby (PJ)

NIHR-Wellcome Trust King's Clinical Research Facility, King's College Hospital, London, UK.
Department of Neurology, University of California, Los Angeles, California, USA.

David W Dodick (DW)

Mayo Clinic, Phoenix, Arizona, USA.

James S McGinley (JS)

Vector Psychometric Group, LLC, Chapel Hill, North Carolina, USA.

Carrie R Houts (CR)

Vector Psychometric Group, LLC, Chapel Hill, North Carolina, USA.

R J Wirth (RJ)

Vector Psychometric Group, LLC, Chapel Hill, North Carolina, USA.

Steve Kymes (S)

Lundbeck LLC, Deerfield, Illinois, USA.

Anders Ettrup (A)

H. Lundbeck A/S, Copenhagen, Denmark.

Ole Østerberg (O)

H. Lundbeck A/S, Copenhagen, Denmark.

Roger Cady (R)

RK Consults, LLC, Ozark, Missouri, USA.

Messoud Ashina (M)

Danish Headache Center, Rigshospitalet Glostrup, University of Copenhagen, Copenhagen, Denmark.

Dawn C Buse (DC)

Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, USA.
Vector Psychometric Group, LLC, Chapel Hill, North Carolina, USA.

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