Headwork as innovative tool for monitoring MABs efficacy in migraine and their influence on work activity
Danilo Antonio Montisano1, Gloria Vaghi2, Alberto Raggi3, Grazia Sances2, Cristina Tassorelli2, Licia Grazzi3
1University of Milano Bicocca, 2IRCCS Mondino Foundation, Pavia, 3Neurological Institute C Besta
Objective:
HEADWORK (HW) is a new evaluation tool, developed specifically to assess the impact on work tasks and reduced productivity of migraineurs. The aim of this study was to test the performance of HW on migraine patients treated with MABs.
Background:
Monoclonal antibodies (MABs) have been a game changer in the treatment of migraine since their approval. Their efficacy is generally assessed with disease related metrics, but there is an increasing need to evaluate the impact of disease treatment.
Design/Methods:
We enrolled 69 patients receiving treatment with MABs at the Headache Centres of IRCCS “C. Besta” (Milan) and IRCCS “C. Mondino” (Pavia). They were assessed with the HEADWORK questionnaire at baseline and at the 3rd (M3) and 6th month (M6) of treatment. HW questionnaire consists of two sections: "Work-related difficulties" (HW1) rates difficulty in general skills, problems solving or starting new task; "Factors contributing to work-related difficulties" (HW2) to asses the negatively impact of some factors, such as noise and brightness of the workplace.
Results:
Population: 15 M and 54 F, mean age (49.5y±8.6), mean age at onset of disease (18y±7), mean duration of disease (34y±11.6). We observed a marked and consistent and significant reduction in ‘classical’ indicators: monthly migraine days (15±5.7 at baseline, 5±5.8 at M3, 6±6.2 at M6), medications per month (15±8.7 at baseline, 5±12.1 at M3, 6±6.6 at M6), MIDAS (41±43.2 at baseline, 6.5±11.3 at M3, 5±13 at M6), HIT-6 (66±2.8 at baseline, 59±8.7 at M3, 59±8.2 at M6). HW scores paralleled the above parameters: HW1 (20±8.1 at baseline, 11±9 at M3, 7±8.2 at M6), HW2 (9±6 at baseline, 5±4.8 at M3, 3±3.8 at M6).
Conclusions:
Our findings confirm the effectiveness of MABs, on clinical markers. HW1 and HW2 also show an extremely positive impact on work related activities. HW appears a suitable tool to assess migraine-related work disability in these patients.