P015 | IMPROVING DISTRESS PERCEPTION IN CAREGIVERS OF MIGRAINE PATIENTS WITH DEPRESSIVE SYMPTOMS TREATED WITH FREMANEZUMAB. THE OBSERVATIONAL PROSPECTIVE REAL-LIFE MI-DEAR STUDY
C. Altamura1|2, L. Fofi1, C. Aurilia3, E. Cresta4, A. Onofri5, A. Montisano6, M. Silvastro7, V. Favoni8, G. Viticchi9, M. Marcosano1, G. Egeo3, M. Bartolini9, M. Peresson10, M. Cepparulo11, A. Russo7, S. Cevoli8, R. Rao4|12, L. Grazzi6, S. Sacco5, F. Vernieri1|2 | 1Neurosonology and Headache Unit, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy; 2Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Italy; 3Headache and Pain Unit, IRCCS San Raffaele Roma, Italy; 4Department of Frailty and Care, Neurology Unit, Headache Center, ASST Spedali Civili, Brescia, Italy; 5Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Italy; 6Headache Center, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy; 7Inter-departmental Program of Headache Medicine and Primary Pain Syndromes, Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, University of Campania “Luigi Vanvitelli”, Naples, Italy; 8Programma cefalee e algie facciali, IRCCS Istituto delle Scienze Neurologiche di Bologna, Italy; 9Neurological Clinic, Marche Polytechnic University, Ancona, Italy; 10Headache Unit, San Pietro Fatebenefratelli Hospital, Rome, Italy; 11Teva Italia Srl, Milan, Italy; 12Department of Clinical and Experimental Sciences (DSCS), University of Brescia, Italy
Abstract
Background. To investigate whether the improvement in the migraine burden alleviates the distress of informal caregivers of patients affected by high-frequency episodic (HFEM) or chronic migraine (CM) with depressive symptoms.
Methods. Consecutive adult patients with HFEM or CM and depressive symptoms who received a prescription of fremanezumab were considered, along with their caregivers. The enrolled dyads have been evaluated before and after 6 months since treatment initiation. In patients, we evaluated monthly migraine days (MMDs), monthly use of acute medications, pain intensity, migraine-related disability (MIDAS) integrated into the composite 4D score, and depressive symptoms (Patient Health Questionnaire-9; PHQ-9). Caregivers filled in the Relative Stress Scale (RSS). The mutuality scale (MS) was also collected in the dyads.
Results. 154 dyads were enrolled (patients aged 42.6 ±12.7 years; 80.5% female; and caregivers aged 48.1±12.2 years; 36.4% female). Of these, 150 completed the 6-month follow-up. After six months of treatment with fremanezumab, MMDs reduced from 15.3±6.5 to 6.3±5.5, the 4D Score from 54.3±11.7 to 30.7±16.9 (p < 0.001), and the PHQ-9 score from 11.4±5.1 to 7.6±4.6 (p < 0.001). PHQ-9 and 4D score variations resulted highly correlated (r = 0.373; p < 0.001). In parallel, caregivers showed a significant reduction in RSS score from 20.0±10.9 to 16.7±11.7 (p < 0.001). Multiple regression analysis showed that the reduction in RSS is primarily related to PHQ improvement (p<0.001) rather than to 4D score improvement (p=0.703). The mutuality scale (MS) scores did not significantly change from T0 to T6 in patients and caregivers
Conclusions. The MI-DEAR study highlighted that caregivers' elevated perceived stress improves after effective migraine management in patients. The improvement in the migraine burden was associated with a reduction in depressive symptoms in patients, which in turn was the main factor alleviating caregivers’ stress.
Claudia Altamura, Luisa Fofi the MIDEAR study group.
Methods. Consecutive adult patients with HFEM or CM and depressive symptoms who received a prescription of fremanezumab were considered, along with their caregivers. The enrolled dyads have been evaluated before and after 6 months since treatment initiation. In patients, we evaluated monthly migraine days (MMDs), monthly use of acute medications, pain intensity, migraine-related disability (MIDAS) integrated into the composite 4D score, and depressive symptoms (Patient Health Questionnaire-9; PHQ-9). Caregivers filled in the Relative Stress Scale (RSS). The mutuality scale (MS) was also collected in the dyads.
Results. 154 dyads were enrolled (patients aged 42.6 ±12.7 years; 80.5% female; and caregivers aged 48.1±12.2 years; 36.4% female). Of these, 150 completed the 6-month follow-up. After six months of treatment with fremanezumab, MMDs reduced from 15.3±6.5 to 6.3±5.5, the 4D Score from 54.3±11.7 to 30.7±16.9 (p < 0.001), and the PHQ-9 score from 11.4±5.1 to 7.6±4.6 (p < 0.001). PHQ-9 and 4D score variations resulted highly correlated (r = 0.373; p < 0.001). In parallel, caregivers showed a significant reduction in RSS score from 20.0±10.9 to 16.7±11.7 (p < 0.001). Multiple regression analysis showed that the reduction in RSS is primarily related to PHQ improvement (p<0.001) rather than to 4D score improvement (p=0.703). The mutuality scale (MS) scores did not significantly change from T0 to T6 in patients and caregivers
Conclusions. The MI-DEAR study highlighted that caregivers' elevated perceived stress improves after effective migraine management in patients. The improvement in the migraine burden was associated with a reduction in depressive symptoms in patients, which in turn was the main factor alleviating caregivers’ stress.
Claudia Altamura, Luisa Fofi the MIDEAR study group.
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