Prevalence and Burden of Migraine in Switzerland: Cross-Sectional Study in ten Specialised Headache Centres from the BECOME Study

Reto Agosti; Catherine Parzini; Oliver Findling; Peter Myers; Jens A Petersen; Philippe Ryvlin; Peter Sandor; Matthias Stallmach; Chiara Zecca; Josefin Snellman; Shannon Ritter; Michael E Arzt; Simon Rohrer; Andreas R Gantenbein

doi:10.1007/s40122-023-00484-3

Prevalence and Burden of Migraine in Switzerland: Cross-Sectional Study in ten Specialised Headache Centres from the BECOME Study

Pain Ther. 2023 Apr;12(2):575-591. doi: 10.1007/s40122-023-00484-3. Epub 2023 Feb 26.

Authors

Reto Agosti¹, Catherine Parzini², Oliver Findling³, Peter Myers⁴, Jens A Petersen⁵, Philippe Ryvlin⁶, Peter Sandor^{7

8

9}, Matthias Stallmach¹⁰, Chiara Zecca^{11

12}, Josefin Snellman¹³, Shannon Ritter¹⁴, Michael E Arzt¹⁵, Simon Rohrer¹⁵, Andreas R Gantenbein¹⁶

Affiliations

¹ Kopfwehzentrum Hirslanden Zürich, Forchstrasse 424, 8702, Zollikon, Switzerland.
² Cabinet Dr. med. Catherine Parzini, 10 Place du Marché-1227, Carouge, Geneva, Switzerland.
³ Kantonsspital Aarau AG, Tellstrasse 25, 5001, Aarau, Switzerland.
⁴ Cabinet Dr. med. Peter John Myers, Neurologue FMH7, Ruelle du Couchant, 1207, Geneva, Switzerland.
⁵ University Hospital Zurich and Neurozentrum, Schänzlistrasse 45, 3013, Bern, Switzerland.
⁶ CHUV Departement des Neurosciences Cliniques, Rue du Bugnon 21, 1011, Lausanne, Switzerland.
⁷ RehaClinic AG, Quellenstrasse 34, 5330, Bad Zurzach, Switzerland.
⁸ University of Zurich, Rämistrasse 71, 8006, Zürich, Switzerland.
⁹ ZURZACH Care AG, Quellenstrasse 34, 5330, Bad Zurzach, Germany.
¹⁰ Neurologie Am Schaulager, Emil-Frey-Str. 85, 4142, Münchenstein, Switzerland.
¹¹ Neurocenter of Southern Switzerland, EOC, Ospedale Regionale di Lugano, Via Tesserete 46, 6900, Lugano, Switzerland.
¹² Faculty of Biomedical Sciences, Università della Svizzera Italiana, Via Giuseppe Buffi 13, 6900, Lugano, Switzerland.
¹³ Novartis Pharma AG, Lichtstrasse 35, 4056, Basel, Switzerland.
¹⁴ Novartis Pharmaceuticals Corporation, East Hanover, NJ, 07936, USA.
¹⁵ Novartis Pharma Schweiz AG, Suurstoffi 14, 6343, Rotkreuz, Switzerland.
¹⁶ ZURZACH Care AG, Quellenstrasse, 34 5330, Bad Zurzach, Switzerland. andreas.gantenbein@zurzachcare.ch.

Abstract

Introduction: There is limited real-world evidence on the burden of migraine among patients with prior preventive treatment failure (PPTF). In the BECOME Swiss subanalysis, we aimed to assess current prevalence of PPTF in patients with migraine seen at specialised headache centres in Switzerland and burden of migraine in these patients. Furthermore, we assessed this burden in subgroups stratified by monthly migraine days (MMDs) and number of PPTFs.

Methods: BECOME was a prospective, multicentre, non-interventional two-part study conducted in 17 countries across Europe and Israel. This subanalysis includes patients visiting ten headache specialist centres in Switzerland. In part 1, patients visiting the centres over 3 months were screened by physicians for frequency of PPTF, MMD and other migraine characteristics. Patients with ≥ 1 PPTF and ≥ 4 MMDs were invited to take part in part 2. The primary endpoint was the proportion of patients with ≥ 1 PPTF (part 1). Other endpoints included proportion of patients specified by number of PPTF and MMD (part 1, part 2), and impact of migraine on patient-reported outcomes (PROs; part 2).

Results: Patients (1677) from ten Swiss centres were included in part 1, of which 855 (51.0%) reported ≥ 1 PPTF. One hundred fifty-five patients were included in part 2: 6.5% reported ≥ 4 PPTFs and 43.2% reported ≥ 15 MMDs. Mean EuroQoL 5 and EuroQoL visual analogue scale (EQ-VAS) were 0.8 ± 0.2 and 69.6 ± 20.2, respectively, suggesting a mild level of impairment in the daily functioning and self-reported health of the patients. Mean six-item Headache Impact Test (HIT-6) and modified Migraine Disability Assessment (mMIDAS) scores were 63.3 ± 6.5 and 22.7 ± 21.8, respectively, corresponding to severe migraine burden. Patients also reported impairment in work-related productivity and general activities (48.6 ± 22.8) but no associations of anxiety (7.2 ± 4.4) or depression (6.0 ± 4.4) with migraine were noted. Burden of migraine increased with increasing frequency of PPTF and MMD.

Conclusions: Migraine-related quality of life, as well as work productivity are significantly affected in Swiss patients with migraine. Increasing migraine burden is associated with increasing migraine frequency and prior treatment failures.

Keywords: Cross-sectional study; Headache; Migraine disorders; Quality of life; Real-world evidence; Surveys and questionnaires; Switzerland; Treatment failure.