QUALITY OF LIFE-RELATED TO WORK PRODUCTIVITY AND PHYSICAL FUNCTIONING IN MIGRAINE PATIENTS: A SYSTEMATIC REVIEW AND NETWORK-META ANALYSIS

Background: Migraine is one of the major causes of disability affecting the productivity, physical, psychological and social well-being of patients. To conduct a systematic review and network meta-analysis (NMA) of randomized trials investigating the effect of anti-calcitonin gene-related peptide monoclonal antibodies (anti-CGRP mAbs) on productivity and physical functioning of adults migraineurs. Methods: Databases were searched from inception to May 2021. Work productivity and physical functioning were evaluated using change in patient-reported Work Productivity and Activity Impairment (WPAI) and Migraine Physical Function Impact Diary (MPFID) scores. The NMA was conducted with fixed-effects model in Bayesian framework. Results: Overall, 26 studies (4,393 migraineurs in five randomized trials) were included with a treatment course of at least 12 weeks. With limited treatments in network formed, subcutaneous injections of fremanezumab 675+225+225 mg QM and 225+225+225 QM were more effective in reducing loss of overall work productivity, activity impairment, and impairment experienced while at work in chronic and episodic migraine, respectively, with the higher median difference in WPAI scores from baseline compared to a low dose of fremanezumab (225 mg single dose). Similarly, the high subcutaneous dose of erenumab (140 mg QM) was more effective with an increase in daily physical activities and decreased physical impairment with a higher median difference in MPFID scores from baseline than its low dose (70 mg QM). Conclusions: For short-term prevention of migraine, high doses of fremanezumab and erenumab demonstrated slightly better productivity and physical functioning than other anti-CGRP mAbs in adult patients with migraine.