Significant Migraine Burden Observed in Patients With at Least 4 Monthly Migraine Days and Prophylactic Treatment Failure

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Patients who have 4 or more migraine days per month and have failed on prophylactic treatment experience reduced quality of life, work productivity, and social activity involvement.

Patients with 4 or more migraine days per month who have failed on prophylactic treatment have reduced quality of life, work productivity, and social activity involvement, according to results of the My Migraine Voice survey.

Migraine significantly affects the lives of patients in all age groups. Among patients under 50 years old, migraine ranks first in years lived with disability.

Although the impact that migraines have on patients has been described in multiple studies, including the American Migraine Prevalence and Prevention Study and the Chronic Migraine Epidemiology and Outcomes study, information regarding patients with high migraine burden, specifically those experiencing 4 or more monthly migraine days and prophylaxis failure, has been limited. The My Migraine Voice survey detailed this patient subgroup.

Approximately 90% of the patients in the survey had taken preventive medication, and more than 80% had experienced 1 or more case of treatment failure. Taking into consideration the entire survey population, investigators found that migraine affected 9.8 days per month on average. Forty-four percent of the patients had migraine that lasted 1 to 2 days or more, and 19% of the patients reported migraine lasting longer than 3 days.


Half of the patients felt that migraine limited their daily activities, with most of the limitations occurring in the headache phase. Headache was also the main symptom that patients reported, along with light and sound sensitivity. Pain associated with migraines scored 7.4 out of 10.0 on average, with 57% of patients categorizing their pain as severe (8.0-10.0).

Patients who had 2 or more treatment failures reported a greater negative impact on daily functions associated with migraines than did those in the overall survey population (88% vs 85%, respectively). These patients also reported more cases of being fearful of experiencing another episode of migraine (33% vs 27%, respectively). Reliance on family and friends for daily tasks was also reported in 64% of patients with 2 or more treatment failures compared with 61% in overall survey population).

In 70% of the patients, migraines reduced work productivity. Some of the most common issues included inability to concentrate at work, missed days of work, and lack of understanding of their condition from coworkers. Missed days at work comprised an average of 4.6 working days, with 60% of patients reporting 1 or more missed days in the past month because of migraines. Although 63% of the patients reported that their employers were aware of their condition, only 9% of them were given disability-related allowance for their migraines.

Results from the survey indicate that although the general population is beginning to recognize the degree of disability that patients with migraines experience, greater understanding is still needed.


Martelletti P, Schwedt TJ, Lanteri-Minet M, et al. My Migraine Voice survey: a global study of disease burden among individuals with migraine for whom preventative treatments have failed. J Headache Pain. 2018;19(1):115. doi: 10.1186/s10194-018-0946-z.