Emgality Treatment for Migraine Prevention Associated with Migraine Burden Improvements According to TRIUMPH Study

Initial results from an ongoing study demonstrated greater improvements in migraine burden for patients who initiated or switched to Emgality (galcanezumab; Lilly, Indianapolis, IN) treatment for a 3 month period compared with other classes of migraine medications, including calcitonin gene-related peptides monoclonal antibodies (CGRP mAbs), traditional oral migraine preventative medications (TOMP), and botulinum toxin A/B. These findings, presented at the 2023 Annual Scientific Meeting of the American Headache Society (AHS), are part of the TRIUMPH study, a 2-year prospective, observational, real-world evidence study assessing outcomes of migraine preventative treatments.

The study took place from February 2020 to August 2022 and included 2573 international adult participants (mean age [SD], 42.7 [13.5] y, 85.2% females) with ICHD-3 diagnosis of migraine (episodic or chronic). Participants completed the following self-administered questionnaires: Migraine Disability Assessment Test (MIDAS), Migraine-Specific Quality of Life Questionnaire (MSQ), version 2.1; Patient Global Impression of Severity (PGI-S); and Work Productivity and Activity Impairment Questionnaire (WPAI). Patients initiated/switched to Galcanezumab (37.0%), TOMP (46.2%), other CGRP mAbs (11.5%), botulinum toxin A/B: (3.3%), or other locally approved medications (1.9%) for a 3 month period. The Emgality group had the greatest mean (SD) change in MIDAS score (-21.2 [45.7]) and WPAI domains of presenteeism (-22.4 [29.1]), work productivity (-24.2 [30.7]), and activity impairment (-23.1 [30.7]). For the MSQ v2.1 domain scores, the Emgality group reported improvement in restrictive [19.6 (24.3)], preventive [15.9 (21.0)], and emotional function scores [22.1 (27.8)]. Mean (SD) change in PGI-S scores at 3 months from baseline were similar across treatment groups (Galcanezumab: -0.4 [1.3], other CGRP mAbs: -0.4 [1.2], OTPM: -0.5 [1.3], botulinum toxin A/B: -0.4 [1.3], other locally approved treatments -0.5 [1.3]).

The results of this study are descriptive, and confirmation of these results requires weighted statistical analyses of patient reported outcomes for subsequent timepoints. The TRIUMPH study is funded by Eli Lilly and includes researchers from a variety of institutions, including the University of Pavia; Headache Science and Neurorehabilitation Centre, IRCCS Mondino Foundation; Headache and Facial Pain Group, UCL Queen Square Institute of Neurology and National Hospital for Neurology and Neurosurgery; Community Neuroscience Services in Westborough, USA; and Harvard Medical School.