Patients' Global Impression of Change (PGIC) Score Compared to Monthly Migraine Days to Evaluate Treatment Persistence With Anti-CGRP Monoclonal Antibodies

This study assessed whether continued treatment with anti-CGRP monoclonal antibodies (mAbs) is driven more by reductions in monthly migraine days (MMDs) or patients' global impression of change (PGIC), a patient-reported outcome. Among 169 patients treated with anti-CGRP mAbs, 21.3% discontinued due to ineffectiveness. PGIC responders (≥ 5) at month 12 were 69.8%, whereas MMD responders (≥ 50% reduction) were 59.2%. Both were significantly associated with discontinuation (PGIC: χ2 = 33.474, φ = 0.445; MMD: χ2 = 29.884, φ = 0.421; p < 0.0001). PGIC showed a stronger correlation with discontinuation (rpb = 0.541) than MMD reduction (rpb = 0.470). These findings highlight PGIC as strongly associated with treatment response, supporting the need for PROMs in evaluating migraine treatment effectiveness.