{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,13]],"date-time":"2026-09-13T08:04:38Z","timestamp":1789286678335,"version":"build-2803163510"},"reference-count":29,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T00:00:00Z","timestamp":1780963200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T00:00:00Z","timestamp":1780963200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["headachejournal.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Headache"],"published-print":{"date-parts":[[2026,9]]},"abstract":"Abstract<\/jats:title>\n \n Objective<\/jats:title>\n To evaluate changes in public interest in calcitonin gene\u2010related peptide therapies associated with major product lifecycle milestones using online search data from the United States and Europe.<\/jats:p>\n <\/jats:sec>\n \n Background<\/jats:title>\n Calcitonin gene\u2010related peptide therapies have transformed migraine treatment, but the impact of key product lifecycle milestones on public awareness remains unclear. As patients increasingly turn to online platforms for health information, events such as trial publications, regulatory approvals, commercial launches, and advertising campaigns may drive search activity and signal broader awareness.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We conducted a retrospective ecological infodemiology study using a quasi\u2010experimental interrupted time\u2010series design with monthly Google Trends data (January 2017\u2013July 2025). Search volume index (0\u2013100 scale) was assessed for seven CGRP\u2010therapies. Milestone events (trial publications, regulatory approvals, commercial launches, and media exposure) were defined a priori as potential drivers of digital impact. We evaluated immediate and sustained changes in search interest following major milestones over time. The primary analysis included all therapies in the United States; secondary analyses evaluated erenumab across five European countries (Germany, France, Italy, Spain, and United Kingdom).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n In the United States, commercial launch was associated with significant immediate increases in search interest for erenumab (\u03b2\u2009=\u2009102.54; 95% confidence interval [CI], 17.05\u2013188.02,\n p<\/jats:italic>\n \u2009=\u20090.021) and galcanezumab (brand search term) (\u03b2\u2009=\u200942.36; 95% CI, 15.80\u201368.91,\n p<\/jats:italic>\n \u2009=\u20090.002). Sustained post\u2010launch growth was observed for fremanezumab (brand search term) (\u03b2\u2009=\u2009+0.50\/month; 95% CI, 0.27\u20130.73,\n p<\/jats:italic>\n \u2009<\u20090.001), eptinezumab (\u03b2\u2009=\u2009+0.45\/month; 95% CI, 0.26\u20130.64,\n p<\/jats:italic>\n \u2009<\u20090.001), rimegepant (brand search term) (\u03b2\u2009=\u2009+0.97\/month; 95% CI, 0.47\u20131.47,\n p<\/jats:italic>\n \u2009<\u20090.001), atogepant (brand search term) (\u03b2\u2009=\u2009+1.28\/month; 95% CI, 0.70\u20131.85,\n p<\/jats:italic>\n \u2009<\u20090.001), and ubrogepant (brand search term) (\u03b2\u2009=\u2009+0.59\/month; 95% CI, 0.42\u20130.77,\n p<\/jats:italic>\n \u2009<\u20090.001). Media exposure was associated with significant immediate increases for erenumab (\u03b2\u2009=\u200994.33; 95% CI, 11.17\u2013177.50,\n p<\/jats:italic>\n \u2009=\u20090.029) and ubrogepant (\u03b2\u2009=\u200929.77; 95% CI, 11.12\u201348.41,\n p<\/jats:italic>\n \u2009=\u20090.003). Regulatory approvals and trial publications were not consistently associated with significant changes in search interest. In Europe, commercial launch was associated with significant immediate increases for erenumab (generic search term) in Italy (\u03b2\u2009=\u2009126.82; 95% CI, 62.12\u2013191.52,\n p<\/jats:italic>\n \u2009<\u20090.001), erenumab (brand search term) in Italy (\u03b2\u2009=\u2009142.98; 95% CI, 23.88\u2013262.08,\n p<\/jats:italic>\n \u2009=\u20090.021) and the United Kingdom (\u03b2\u2009=\u200969.44; 95% CI, 6.71\u2013132.16,\n p<\/jats:italic>\n \u2009=\u20090.033). Post\u2010launch trends were generally negative across countries, indicating gradual declines after initial spikes.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Commercial launch was the most consistent driver of public search interest in CGRP\u2010targeting therapies. Media exposure produced additional increases in selected cases, whereas regulatory approvals and clinical trial publications had limited measurable impact. These findings underscore the dominant role of commercial and consumer\u2010facing communication in shaping public awareness of new migraine treatments.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/head.70136","type":"journal-article","created":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T04:58:56Z","timestamp":1781067536000},"page":"1788-1800","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Online interest in calcitonin gene\u2010related peptide\u2010therapies: An infodemiology study using Google trends"],"prefix":"10.1111","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6507-1967","authenticated-orcid":false,"given":"Bradley","family":"Ong","sequence":"first","affiliation":[{"name":"Department of Neurology Neurological Institute, Cleveland Clinic Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6793-417X","authenticated-orcid":false,"given":"Jad El","family":"Ahdab","sequence":"additional","affiliation":[{"name":"Sleep Disorders Center Neurological Institute Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Thompson","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences Cleveland Clinic Cleveland Ohio USA"},{"name":"Center for Outcomes Research & Evaluation Neurological Institute, Cleveland Clinic Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maithili","family":"Bhagat","sequence":"additional","affiliation":[{"name":"Ohio University Heritage College of Osteopathic Medicine Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Ney","sequence":"additional","affiliation":[{"name":"Yale University School of Medicine New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison L.","family":"Weathers","sequence":"additional","affiliation":[{"name":"Department of Neurology Neurological Institute, Cleveland Clinic Cleveland Ohio USA"},{"name":"Information Technology Division Cleveland Clinic Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,9]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)32342-4"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/head.14692"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pdig.0000279"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/0333102420942241"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaophthalmol.2022.1000"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0109583"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.3284"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2019.20288"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-53554-7"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.9370"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.2196\/13120"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctim.2021.102682"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-147-8-200710160-00010-w1"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/asj\/sjad211"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2022.884211"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.3390\/v14061325"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/cpt.1"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2019-032701"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(24)00521-7"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pdig.0000313"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.23968"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001785"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-018-6202-2"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.19320"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa070502"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12929-019-0592-z"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwac171"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.2146"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.2196\/13369"}],"container-title":["Headache: 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