ArticleNeurology and therapy2026
Real-World Experience with Anti-CGRP Pathway Monoclonal Antibodies in a Large United States Healthcare Plan: Results of the Migraine Signature Study.
Article in Neurology and therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionCalcitonin gene-related peptide (CGRP) pathway-targeted monoclonal antibodies (mAbs) are first-line treatment options for migraine prevention. Data on persistence and patient-reported outcomes including satisfaction are limited. This real-world study aimed to report the experience of patients prescribed ≥ 1 self-injectable anti-CGRP mAb in a large United States healthcare network.
methodsThe Migraine Signature Study, an observational study, conducted at Sutter Health, utilized electronic health records (EHRs) to identify adult patients with migraine who were prescribed ≥ 1 self-injectable anti-CGRP mAb. These patients were invited to participate in a survey (October-December 2020) on sociodemographics, migraine attack characteristics, treatment patterns, and patient-reported outcomes, including the Migraine Disability Assessment Scale (MIDAS) and 4-item Migraine Interictal Burden Scale (MIBS-4). EHRs were used to assess persistence/discontinuation.
resultsOf 4683 eligible patients with migraine, 484 (10.3%) completed the survey. More than half (51%) were 30-54 years old, female (89.1%), and non-Hispanic white (79.1%). Most (53.5%) reported 1-10 headache days in the previous month; 58.2% had moderate or severe migraine-related disability. A total of 430 respondents reported having used ≥ 1 anti-CGRP mAbs, comprising 547 reports of anti-CGRP-mAb experience, 319 (58.3%) current use, and 228 (41.7%) past use. Among participants with prescription-dispensing data (n = 338), ongoing refills were documented for ≥ 2 months in 90.2%, ≥ 6 months in 73.7%, and ≥ 12 months in 54.7%. Greater reduction in number of headache/migraine attacks (62.1% vs. 17.5%), improved ability to function (62.1% vs. 18.0%), and better quality of life (62.4% vs. 17.5%) was reported for current use versus past.
conclusionAmong patients who dispensed ≥ 1 anti-CGRP mAb for migraine, rates of sustained treatment over the course of a year were higher than expected; ~ 75% continued their index mAb at 6 months and > 50% at 12 months. Patients using anti-CGRP mAbs at the time of the survey reported higher satisfaction than patients who had discontinued anti-CGRP mAb.
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