Abstract text (incl. figure legends and references)

Objective:To assess self-reported use of preventive medications for migraine available in 2021 and analyze potential treatment gaps among individuals who are candidates for preventive treatment based on the American Headache Society (AHS) Consensus Statement (ie, ≥3 monthly headache days [MHDs] with severe disability, ≥4 MHDs with some disability, or ≥6 MHDs regardless of disability level).

Methods:CaMEO-I was a cross-sectional, observational, web-based cohort study conducted in 2021 in the US, Canada, UK, Germany, France, and Japan. Respondents who met International Classification of Headache Disorders, 3rd ed symptom criteria were eligible to participate in the survey assessment.

Results:Of 14,492 respondents with migraine included in this analysis (≈2400 from each country), 31.5-42.1% qualified for migraine preventive treatment based on the AHS Consensus Statement (US: n=976; Canada: n=794; UK: n=767; Germany: n=1010; France: n=802; Japan: n=897). In the overall sample, respondents who reported ever using a preventive medication for migraine ranged from 9.7% (Japan) to 28.9% (US). Among those who reported ever using a preventive medication, 51.1-65.8% were current users. Among current users, 70.6-97.1% used an oral preventive medication, 1.7-16.5% used an injectable preventive medication, and 1.3-20.9% used both. The majority of respondents with migraine who qualified for preventive treatment did not report currently using a preventive (77.6-89.9%); 30.0-40.8% of respondents who were not currently using a preventive qualified for preventive treatment. Of respondents who were currently using a preventive, 41.1-59.1% still qualified for preventive treatment.

Conclusions:More than 75% of individuals with migraine who are candidates for a preventive treatment are not currently taking a medication to prevent migraine. Of those who are currently using a preventive medication for migraine, roughly 50% are not receiving adequate benefit from their current medication.