Peer Reviewed

Health Care Disparities

Gender, Race Impacts the Care of Patients With Migraine

Subgroup disparities such as gender and race may be more distinct in patients with migraine, according to the results of a new study presented at the American Academy of Neurology’s 2021 Virtual Annual Meeting.

The researchers conducted an analysis of an annual cross-sectional patient chart audit to explore the role of subgroup disparities in these patient populations. Chart review data was contributed by 230 US physicians between May and June 2020.

A total of 1003 patients who had been recently prescribed a calcitonin gene-related peptide monoclonal antibody or onabotulinumtoxinA were included in the analysis. Gender (women, n = 710, men, n =293), race (White, n = 765), and minorities (Black, Latino/Hispanic, Asian, and other, n = 238) were among the subgroups examined.

The results indicated that women participants had experienced their first migraine episode (22.7 years vs 29.1 years) and had been diagnosed (26.1 years vs 32.0 years) at a younger age than men participants. Men had higher rates of diagnosis for low-frequency episodic migraine than women (28% vs 13%), while more women were diagnosed with chronic migraine (41% vs 24%), anxiety (17% vs 8%), and depression (27% vs 21%) than men. However, management by a migraine specialist was more common among men than women (52% vs 36%), especially among minority men (56%) compared with White women (35%).

In addition, men were more likely than women to have been prescribed fremanezumab (22% vs 17%) or eptinezumab (9% vs 5%). While 51% of men had previously failed 1 preventive therapy, 68% of women had failed 2 or more therapies.

Further, White participants were found to be younger than minority participants at both first migraine episode and diagnosis. Comorbid hypertension was more common among men and minorities. White men and minority women had the highest rates of comorbid hypertension.

Therapy selection among minority groups was more likely to be influenced by patient request, efficacy onset speed expectation, family planning consideration, and nonadherence concern.

“Subgroup disparities reported for the general US population exist and are even more significant in the migraine community. Stakeholders in migraine care should acknowledge and address these disparities,” the researchers concluded.


—Leigh Precopio



Cowan R, Stabb M, Robinson N, Schobel V. Understanding the impact of sex and race on the migraine patient’s journey in the United States: analyses from an annual cross-sectional patient chart audit. Paper presented at: American Academy of Neurology’s 2021 Virtual Annual Meeting; April 17-22, 2021; Virtual.