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The German treatment guidelines recommend discontinuing successful treatment with CGRP(\u2212receptor) mAbs after 6\u201312\u2009months. We aimed to evaluate headache-specific and generic HRQoL for three months after discontinuation of CGRP(\u2212receptor) mAb treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a prospective, longitudinal cohort study, including patients with migraine after 8\u201312\u2009months of therapy with a CGRP(\u2212R) mAb and before a planned discontinuation attempt. HRQoL was assessed at the time of the last mAbs injection (V1), eight weeks later (V2), and sixteen weeks later (V3). For headache-specific HRQoL, we used the Headache Impact Test-6 (HIT-6). Generic HRQoL was determined with the EuroQol-5-Dimension-5-Level (ED-5D-5L) form, and the Short-Form 12 (SF-12), which comprises a Physical Component Summary (PCS-12) and a Mental Component Summary (MCS-12).<\/jats:p><jats:p>Questionnaires\u2019 total scores were compared across the three observation points using nonparametric procedures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study cohort consisted of<jats:italic>n<\/jats:italic>\u00a0=\u200961 patients (<jats:italic>n<\/jats:italic>\u00a0=\u200929 treated with the CGRP-receptor mAb erenumab and<jats:italic>n<\/jats:italic>\u00a0=\u200932 with the CGRP mAbs galcanezumab or fremanezumab). The HIT-6 sum score was 59.69\u2009\u00b1\u20096.90 at V1 and increased by 3.69\u2009\u00b1\u20096.21 at V3 (<jats:italic>p<\/jats:italic>\u00a0&lt;\u20090.001), indicating a greater headache impact on patients\u2019 lives. The mean total EQ-D5-L5 score declined from 0.85\u2009\u00b1\u20090.17 at V1 by \u2212\u20090.07\u2009\u00b1\u20090.18 at V3 (<jats:italic>p<\/jats:italic>\u00a0=\u20090.013). Both Mental and Physical Component Scores of the SF-12 worsened significantly during treatment discontinuation: The PCS-12 total score decreased by \u2212\u20094.04\u2009\u00b1\u20097.90 from V1 to V3 (<jats:italic>p<\/jats:italic>\u00a0=\u20090.013) and the MCS-12 score by \u2212\u20092.73\u2009\u00b1\u20099.04 (<jats:italic>p<\/jats:italic>\u00a0=\u20090.003). Changes in all questionnaires\u2019 scores but the MCS-12 were already significant in the first month of the drug holiday (V2).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our results show a significant decline in headache impact and generic HRQoL of migraine patients after treatment discontinuation of a CGRP(\u2212R) mAb. The observed deterioration is above the established minimally clinically important differences for each of the questionnaires and can therefore be considered clinically meaningful. Monitoring HRQoL during a discontinuation attempt could facilitate the decision whether or not to resume preventive treatment with CGRP(\u2212R) mAbs.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s10194-021-01368-7","type":"journal-article","created":{"date-parts":[[2021,12,31]],"date-time":"2021-12-31T10:02:34Z","timestamp":1640944954000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Deterioration of headache impact and health-related quality of life in migraine patients after cessation of preventive treatment with CGRP(\u2212receptor) antibodies"],"prefix":"10.1186","volume":"22","author":[{"given":"Maria","family":"Terhart","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasper","family":"Mecklenburg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"Neeb","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas Hendrik","family":"Overeem","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anke","family":"Siebert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maureen","family":"Steinicke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9758-1494","authenticated-orcid":false,"given":"Bianca","family":"Raffaelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uwe","family":"Reuter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,12,31]]},"reference":[{"issue":"5","key":"1368_CR1","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1212\/01.wnl.0000252808.97649.21","volume":"68","author":"RB Lipton","year":"2007","unstructured":"Lipton RB, Bigal ME, Diamond M, Freitag F, Reed ML, Stewart WF (2007) Migraine prevalence, disease burden, and the need for preventive therapy. 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UR received honoraria for consulting and lectures from Amgen, Allergan, Abbvie, Eli Lilly, Lundbeck, Novartis, electroCore, Medscape, StreaMedUp, and Teva; UR received research funding from the German Federal Ministry of Education and Research and Novartis. The other authors have nothing to disclose.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"158"}}