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The Capital Region of Denmark - a part of Copenhagen University Hospital
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Predicting treatment response using pharmacy register in migraine

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BACKGROUND: Precision medicine may offer new strategies to treat migraine, and access to existing large cohorts may be a key resource to increase statistical power. Treatment response data is not routinely collected for large cohorts; however, such information could be extracted from pharmacy databases. Using a clinical migraine sample with treatment effect data, we assessed whether treatment response can be predicted based on the number of drug purchases.

METHODS: A clinical cohort including 1913 migraineurs were interviewed using a semi-structured interview to retrieve treatment response data for acute and prophylactic migraine drugs. The purchase history was obtained from the Danish national pharmacy database. We assessed whether number of purchases at different thresholds could predict the specificity and sensitivity of treatment response.

RESULTS: Purchase history of drugs was significantly associated with treatment response. For triptan treatment the specificity and sensitivity were above 80% for individuals with at least ten purchases. For prophylactic treatment (beta-blockers, angiotensin II antagonists or antiepileptic) we observed a sensitivity and specificity above 80% and 50% for individuals purchasing any prophylactic drug at least four times. In the Danish pharmacy database, 73% of the migraine patients have purchased at least ten triptans, while 55-63% have purchased at least one of the four prophylactic drugs.

CONCLUSION: Pharmacy databases are a valid source for identification of treatment response. Specifically for migraine drugs, we conclude that ten purchases of triptans or four purchases of prophylactic drugs are sufficient to predict a positive treatment response. Precision medicine may be accelerated with the use of pharmacy databases.

Original languageEnglish
JournalJournal of Headache and Pain
Volume20
Issue number1
Pages (from-to)20-31
Number of pages8
ISSN1129-2377
DOIs
Publication statusPublished - 2019

    Research areas

  • Adrenergic beta-Antagonists, Adult, Analgesics/therapeutic use, Cohort Studies, Databases, Factual/statistics & numerical data, Female, Humans, Male, Middle Aged, Migraine Disorders/drug therapy, Pharmacies/statistics & numerical data, Precision Medicine, Treatment Outcome

ID: 58897639