The Registry for Migraine (REFORM) study: methodology, demographics, and baseline clinical characteristics

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Background: Erenumab has demonstrated effectiveness for prevention of migraine attacks, but the treatment is costly, and a considerable proportion of patients do not respond to it. The Registry for Migraine study (REFORM) was initiated to discover biomarkers that can predict response to erenumab in patients with migraine. The specific objective was to investigate differences in erenumab efficacy based on clinical information, blood-based biomarkers, structural and functional magnetic resonance imaging (MRI), and response to intravenous infusion of calcitonin gene-related peptide (CGRP). In this first report of the REFORM study, we provide a comprehensive description of the study methodology, and present the baseline characteristics of the study population. Methods: The REFORM study was a single-center, prospective, longitudinal cohort study in adults with migraine who were scheduled to receive preventive treatment with erenumab as part of a separate, open-label, single-arm phase IV trial. The study included four periods: a 2-week screening period (Weeks -6 to -5), 4-week baseline period (Week -4 to Day 1), 24-week treatment period (Day 1 to Week 24), and a 24-week follow-up period without treatment (Week 25 to Week 48). Demographic and clinical characteristics were recorded using a semi-structured interview, whilst outcome data were obtained using a headache diary, patient-reported outcomes, blood sampling, brain MRI, and responsiveness to intravenous infusion of CGRP. Results: The study enrolled 751 participants, with a mean age ± SD of 43.8 ± 12.2 years, of which 88.8% (n = 667) were female. At enrollment, 64.7% (n = 486) were diagnosed with chronic migraine, and 30.2% (n = 227) had history of aura. The mean monthly migraine days (MMDs) was 14.5 ± 7.0. Concomitant preventive medications were used by 48.5% (n = 364) of the participants, and 39.9% (n = 300) had failed ≥ 4 preventive medications. Conclusion: The REFORM study enrolled a population with a high migraine burden and frequent use of concomitant medications. The baseline characteristics were representative of patients with migraine in specialized headache clinics. Future publications will report the results of the investigations presented in this article. Trial registration: The study and sub-studies were registered on ClinicalTrials.gov (NCT04592952; NCT04603976; and NCT04674020).

OriginalsprogEngelsk
Artikelnummer70
TidsskriftJournal of Headache and Pain
Vol/bind24
Antal sider12
ISSN1129-2369
DOI
StatusUdgivet - 2023

Bibliografisk note

Funding Information:
We would like to express our gratitude to the study participants, Professor Timothy J. Steiner, the staff at the Danish Headache Center (Ane Lundgaard Dahl, Anne Mette Autzen, Dianna Bartolin Christiansen, Kateryna Kolkova, Marianne Hestad, Pia Frydendall, and Susanne Leed) and medical students affiliated with the Human Migraine Research Unit (Amanda Poulsen, Amenah Ayyoub, Amir Al-Saoudi, Astrid Wiggers, Emil Gozalov, Kathrine Rose, Mikkel Johannes Henningsen, Mohammed Bakir Ahmad Lafta, Johanne Gry Larsen, Sarra Al-Khazali, and Shan Elahi Goandal). REFORM investigators included in addition to named authors: Afrim Iljazi , Andreas Vinther Thomsen , Basit Ali Chaudhry , Betel Tesfay , Janu Thuraiaiyah , Lili Kokoti , Nadja Bredo Rasmussen , Rogelio Domínguez-Moreno , Thien Phu Do , and Zixuan Alice Zhuang from the Department of Neurology, the Danish Headache Center, Copenhagen University Hospital—Rigshospitalet, Copenhagen, Denmark.

Funding Information:
This study received funding from Novartis Pharma AG. MA was supported by the Lundbeck Foundation professor grant (R310-2018–3711).

Publisher Copyright:
© 2023, The Author(s).

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