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InterMiG: international differences in the therapeutic approach to migraine patients in specialized headache centers Huhn, J-I Latysheva, N Vieira Campos, A Torres Ferrús, Marta Gallardo Lopez, Victor José Pozo Rosich, Patricia Alpuente Ruiz, Alicia Gago-Veiga, Ana Beatriz Institut Català de la Salut [Gago-Veiga AB, Vieira Campos A] Headache Unit, Department of Neurology, La Princesa Research Institute. Hospital Universitario de la Princesa, Madrid, Spain. [Huhn JI] Praxis Gendolla. Zentrum für Neurologie und Schmerztherapie, Essen, Germany. [Latysheva N] Department of Neurology, Institute for Professional Education, I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia. [Torres-Ferrus M, Alpuente Ruiz A, Gallardo VJ, Pozo-Rosich P] Unitat de Cefalees, Servei de Neurologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Grup de Recerca en Cefalees i Dolors Neurològics, Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain Vall d'Hebron Barcelona Hospital Campus Migranya - Tractament Medicina - Estudi de casos DISEASES::Nervous System Diseases::Central Nervous System Diseases::Brain Diseases::Headache Disorders::Headache Disorders, Primary::Migraine Disorders Other subheadings::Other subheadings::Other subheadings::/drug therapy ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics::Epidemiologic Studies::Case-Control Studies::Retrospective Studies ENFERMEDADES::enfermedades del sistema nervioso::enfermedades del sistema nervioso central::enfermedades cerebrales::trastornos con cefaleas::cefaleas primarias::trastornos migrañosos Otros calificadores::Otros calificadores::Otros calificadores::/farmacoterapia TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::técnicas de investigación::métodos epidemiológicos::características de los estudios epidemiológicos::estudios epidemiológicos::estudios de casos y controles::estudios retrospectivos Antidepressiu; Migranya; Tractament preventiu Antidepresivo; Migraña; Tratamiento preventivo Antidepressant; Migraine; Preventive treatment Background There is currently a wide therapeutic arsenal for migraine patients, without a single first-line preventive drug and we choose the different available alternatives taking into account comorbidities, national guidelines, previous treatments and personal experiences. Our objective was to evaluate the differences in the use of migraine treatments between neurologists from different countries. Methods This is a multi-centre observational study carried out by neurologists from specialized headache units in seven countries, retrospective with consecutive inclusion of all patients presenting with a migraine diagnosis, over a period of three months. Results A total of 734 patients were recruited but only 600 were considered in the analysis in order to homogenize the patient cohorts from countries: 200 Spain (ES), 100 Italy (IT), 85 Russia (RUS), 80 Germany (DE), 60 Portugal (PT), 45 Poland (PL) and 30 Australia (AU). 85.4 % of patients were women with a mean age of 42.6 ± 11.8 years. Considering previous and current preventive treatment, the order of use was: antidepressants (69.3 %), antiepileptic drugs (54.7 %), beta-blockers and antihypertensive drugs (49.7 %), OnabotulinumtoxinA (44.0 %) and others (36.2 %). Statistically significant differences were found between all pharmacological classes: antidepressants were commonly used in all countries, with the exception of Poland (AU: 76.7 %, IT: 71.0 %, DE: 60.0 %, PL: 31.1 %, PT: 71.7 %, RUS: 70.6 %, ES: 78.5 %; p < 0.0001); antiepileptic drugs were more frequently prescribed in Portugal, Australia and Spain (AU: 73.3 %, IT: 40.0 %, DE: 37.5 %, PL: 48.9 %, PT: 85.0 %, RUS: 29.4 % and ES: 69.0 %; p < 0.0001); beta-blockers and antihypertensive drugs were frequently used in all countries except Italy (AU: 60.0 %, IT: 14.0 %, DE: 53.8 %, PL: 48.9 %, PT: 68.3 %, RUS: 49.4 % and ES: 59.0 %; p < 0.0001); BTX-A were predominately used in Spain, Italy and Australia (AU:56.7 %, IT:58.0 %, DE:20.0 %, PL: 42.2 %, PT: 26.7 %, RUS: 24.7 % and ES: 58.5 %; p < 0.0001) and others were most frequently used in Poland (AU: 0.0 %, IT: 19.0 %, DE: 42.5 %, PL: 95.6 %, PT: 31.7 %, RUS: 3.5 % and ES: 49.5 %; p < 0.0001). If only patients without comorbidities are considered (200/600), statistically differences between countries persist in all preventive treatments. Conclusions There is heterogeneity in the choice of preventive treatment between different countries. Prospective comparative studies of the different oral and subcutaneous alternatives would help to create a global therapeutic algorithm that would guarantee the best option for our patients. This work did not receive any funds. 2022-01-20T08:59:17Z 2022-01-20T08:59:17Z 2021-05-24 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Gago-Veiga A, Huhn JI, Latysheva N, Vieira Campos A, Torres-Ferrus M, Alpuente Ruiz A, et al. InterMiG: international differences in the therapeutic approach to migraine patients in specialized headache centers. J Headache Pain. 2021 May 24;22:43. 1129-2369 https://hdl.handle.net/11351/6836 10.1186/s10194-021-01258-y 34030634 000656151400002 http://hdl.handle.net/11351/6836 eng The Journal of Headache and Pain;22 https://doi.org/10.1186/s10194-021-01258-y Attribution 4.0 International http://creativecommons.org/licenses/by/4.0/ info:eu-repo/semantics/openAccess application/pdf BMC Scientia