Abstract / Summary
Aim: In Japan, the introduction of anti-calcitonin gene-related peptide (CGRP) monoclonal antibodies and the 5-HT1F receptor agonist lasmiditan has transformed migraine treatment. However, medical consultation and prescription rates for migraine remain low. This study aimed to clarify the awareness and prescribing patterns of acute and preventive migraine medications among physicians in Kawasaki, Japan.
Methods: A questionnaire survey of 1274 physicians registered with the Kawasaki Medical Association was conducted from December 2024 to February 2025. Responses were collected via fax or web form, and data were analyzed according to medical specialty.
Results: A total of 288 physicians responded (response rate, 22.6%). General internists accounted for 49.3%, followed by neurologists (5.9%) and neurosurgeons (3.8%). For acute treatment, 65.9% of the respondents primarily prescribed acetaminophen or nonsteroidal anti-inflammatory drugs. Although 87.8% were aware of triptans, only 64.1% prescribed them. Awareness and prescription of lasmiditan and anti-CGRP monoclonal antibodies were particularly low among nonspecialists and were significantly lower than those among specialists (p < 0.008). In the multivariable analysis, specialty was not independently associated with triptan prescribing, whereas specialists were markedly more likely to prescribe anti-CGRP monoclonal antibodies (adjusted OR 42.6).
Conclusion: In Kawasaki, awareness and use of new migraine therapies remain limited, especially among nonspecialists. Specialty independently influenced the prescription of anti-CGRP monoclonal antibodies but not triptans, highlighting the need for enhanced education and collaboration with headache specialists to improve migraine care.