Assessing Effectiveness of CGRP mAb Tx in Migraineurs With Additional MOH, MO

Background: Medication overuse (MO) and medication overuse headache (MOH) are common in migraine and have historically driven detoxification-first strategies, despite frequent relapse and uncertainty about whether detox is required before starting preventive therapy. Real-world data on calcitonin gene-related peptide (CGRP) monoclonal antibodies (mAbs) started without detox are needed. Objective: To assess up to 12-month effectiveness of CGRP (receptor) antibodies in migraine patients with versus without MO/MOH without prior detoxification, including MO/MOH resolution and relapse. Design: Retrospective routine-care analysis at University Hospital Essen (Germany), November 2018 to May 2023; outcomes compared from baseline to last observation time point (LOTP) within the first year. Methods: 291 patients were included: episodic migraine with MO (EM-MO; n=35), EM without MO (EM-noMO; n=77), chronic migraine with MOH (CM-MOH; n=109), CM without MOH (CM-noMOH; n=70). Therapies including e more...