Statistics quick reference — migraine
Last audited: 2026-08-30; amylin row added 2026-10-20 from a live PubMed abstract; four rows (Africa GBD, England CPRD, US MIND claims, multi-ancestry GWAS preprint) added 2026-10-27 from live PubMed records, pending audit. Figures are reusable only with their population, method and uncertainty.
Disease scale and burden
| Figure |
Population / method |
Year |
Source |
| 1.2 billion people modelled with migraine |
GBD 2023, hierarchical Bayesian synthesis |
2023 |
GBD 2023 Collaborators, PMID 41240916 |
| Cases rose 58.15%, 732.56 million to 1.16 billion |
Re-analysis of GBD 1990–2021; growth includes demography/model effects |
1990–2021 |
Dong 2025, PMID 39661241 |
| Approximate annual prevalence 6% in men, 15–18% in women |
Older US population synthesis |
published 1997 |
Lipton 1997, PMID 9058393 |
| <5% reached specialist care in older epidemiology |
Historical US epidemiology |
published 1993 |
Silberstein 1993, PMID 8272178 |
| Current acute prescription: 22.9%; discontinued: 12.6%; none: 64.5% |
CaMEO, 13,624 US respondents |
published 2020 |
Hutchinson 2020, PMID 32247344 |
| Africa (53 African Union countries): 180.4 million prevalent cases (95% UI 152.2–211.3), 6.1 million DALYs (4.1–8.5), age-standardized prevalence 13,385.8/100,000; projected ~375.7 million cases by 2050 |
Secondary analysis of GBD 2023 with ARIMA projection; projection is model extrapolation |
2023 |
Lu 2026, PMID 42920904 |
| England primary care: 57.1% of 1,534,807 headache/migraine presenters coded undifferentiated; of 476,191 adults with migraine, 36.5% prescribed a preventive, 36.6% a triptan, 9.6% an opioid; recommended dose reached by 17.9% (amitriptyline), 31.3% (propranolol), 31.2% (topiramate) |
CPRD Aurum retrospective cohort 2012–2023; prescriptions, not use; Pfizer-funded |
2012–2023 |
Watson 2026, PMID 41513289 |
| US newly diagnosed adults (n=154,353): 47.0% diagnosed in primary care; within 3 years 72.1% filled any migraine medication, 46.1% an opioid, 12.5% butalbital; first preventive was a CGRP mAb in 8.1% and a gepant in 1.2% |
Optum Market Clarity claims, index 2018–2021, ≥36 months follow-up; descriptive; Pfizer-funded |
2018–2024 |
Cohen 2026, PMID 42929214 |
Interpretation: GBD is a modelled comparative-burden system, not one global survey. Do not compare releases without accounting for changed inputs and time-symptomatic adjustment.
Diagnostic and frequency thresholds
| Rule |
Exact threshold |
Source |
| Migraine without aura |
≥5 attacks, 4–72 h, specified pain and associated features |
ICHD-3, PMID 29368949 |
| Migraine with aura |
≥2 attacks; ≥3 of 6 temporal/phenotypic features |
ICHD-3, PMID 29368949 |
| Chronic migraine |
≥15 headache days/month for >3 months; migraine features/response on ≥8 days |
ICHD-3, PMID 29368949 |
| MOH general frame |
≥15 headache days/month plus >3 months regular class-threshold overuse |
ICHD-3, PMID 29368949 |
| Triptan/opioid/combination overuse |
≥10 days/month |
ICHD-3, PMID 29368949 |
| Simple analgesic/NSAID overuse |
≥15 days/month |
ICHD-3, PMID 29368949 |
These are operational diagnostic cutoffs, not demonstrated biological discontinuities.
Acute treatment effects
| Intervention / outcome |
Active |
Placebo / comparator |
Effect |
Source |
| Rimegepant ODT, 2-h pain freedom |
21% |
11% |
RD 10% (95% CI 6–14) |
Croop 2019, PMID 31311674 |
| Rimegepant, 2-h MBS freedom |
35% |
27% |
RD 8% (3–13) |
Croop 2019, PMID 31311674 |
| Ubrogepant 50 mg, 2-h pain freedom |
21.8% |
14.3% |
RD 7.5% (2.6–12.5) |
Lipton 2019, PMID 31742631 |
| Ubrogepant 50 mg, 2-h MBS freedom |
38.9% |
27.4% |
RD 11.5% (5.4–17.5) |
Lipton 2019, PMID 31742631 |
| Zavegepant nasal, 2-h pain freedom |
24% |
15% |
RD 8.8% (4.5–13.1) |
Lipton 2023, PMID 36804093 |
| Zavegepant nasal, 2-h MBS freedom |
40% |
31% |
RD 8.7% (3.4–13.9) |
Lipton 2023, PMID 36804093 |
| Oral drugs vs placebo, 2-h pain freedom |
— |
— |
OR 1.73 (1.27–2.34), naratriptan, to 5.19 (4.25–6.33), eletriptan |
Karlsson 2024, PMID 39293828 |
| Eletriptan vs other active drugs |
— |
— |
network OR range 1.46–3.01 |
Karlsson 2024, PMID 39293828 |
MBS = most bothersome symptom; RD = risk difference. Pivotal gepant absolute benefits are real and modest; network odds ratios are not equivalent to risk differences.
Prevention effects
| Trial / population |
Active result |
Control result |
Contrast / interpretation |
Source |
| STRIVE erenumab 70/140 mg, episodic |
MMD −3.2 / −3.7 |
−1.8 |
active–placebo −1.4 / −1.9 |
Goadsby 2017, PMID 29171821 |
| STRIVE ≥50% response |
43.3% / 50.0% |
26.6% |
absolute +16.7 / +23.4 points |
Goadsby 2017, PMID 29171821 |
| Rimegepant preventive |
MMD −4.3 |
−3.5 |
LSMD −0.8 days (95% CI −1.46 to −0.20) |
Croop 2021, PMID 33338437 |
| HER-MES discontinuation due to AEs |
erenumab 10.6% |
topiramate 38.9% |
−28.3 points |
Reuter 2022, PMID 34743579 |
| HER-MES ≥50% response |
erenumab 55.4% |
topiramate 31.2% |
+24.2 points |
Reuter 2022, PMID 34743579 |
| Preventive network meta-analysis |
74 trials; 32,990 participants |
multiple drugs/placebo |
high-certainty responder evidence for CGRP agents and topiramate |
Lampl 2023, PMID 37208596 |
| TEMPLE AE discontinuation |
atogepant 12% (33/273) |
topiramate 30% (79/267) |
RR 0.4 (95% CI 0.3–0.6) |
Reuter 2026, PMID 42492556 |
| TEMPLE ≥50% response |
atogepant 64% (173/270) |
topiramate 39% (101/257) |
RR 1.6 (95% CI 1.4–2.0) |
Reuter 2026, PMID 42492556 |
| TEMPLE MMD change |
atogepant −6.3 |
topiramate −4.5 |
LS mean difference −1.8 days (95% CI −2.5 to −1.0) |
Reuter 2026, PMID 42492556 |
Chronic migraine and medication overuse
| Figure |
Context |
Source |
| Chronic migraine affects roughly 1–2% of population and ~8% of people with migraine |
Review synthesis; definitions/studies vary |
May 2016, PMID 27389092 |
| Approximate annual episodic-to-chronic conversion near 3% |
Older synthesis; causal factors unresolved |
May 2016, PMID 27389092 |
| Approximate two-year remission near 26% |
Frequency categories are dynamic |
May 2016, PMID 27389092 |
| PREEMPT pooled n=1,384 |
Two phase 3 chronic-migraine trials |
Dodick 2010, PMID 20487038 |
| Withdrawal + early prevention yielded highest six-month MOH cure |
Randomized strategy trial; exact regimen/context required |
Carlsen 2020, PMID 32453406 |
Pediatric evidence
| Figure |
Population |
Source |
| CHAMP randomized n=361, ages 8–17 |
Pediatric migraine prevention |
Powers 2017, PMID 27788026 |
| ≥50% response: amitriptyline 52%, topiramate 55%, placebo 61% |
Trial stopped for futility; more active-arm harms |
Powers 2017, PMID 27788026 |
| CBT + amitriptyline reduced headache days/disability more than education + amitriptyline |
Pediatric chronic migraine; isolates CBT increment, not amitriptyline necessity |
Powers 2013, PMID 24368463 |
Menstrual and reproductive statistics
| Figure |
Population / method |
Source |
| Menstrual migraine about 20–25% of women with migraine |
Population synthesis; clinic estimates higher |
Vetvik 2021, PMID 33600767 |
| Pure menstrual migraine <1%; self-report vs diary κ=0.28 |
607-woman electronic diary study |
Verhagen 2022, PMID 35514214 |
| 49 women followed prospectively showed increasing improvement across pregnancy and postpartum recurrence |
Small prospective cohort |
Sances 2003, PMID 12662187 |
| 69,929 pregnancies: no overall first-trimester triptan major-malformation association |
Norwegian observational cohort; residual confounding/drug mix |
Nezvalová-Henriksen 2010, PMID 20132339 |
Genetics and biomarkers
| Figure |
Population / method |
Source |
| 102,084 cases; 771,257 controls; 123 loci, 86 new |
GWAS meta-analysis |
Hautakangas 2022, PMID 35115687 |
| Subtype analysis n=29,679 cases |
Shared and subtype-specific signals |
Hautakangas 2022, PMID 35115687 |
| 206,893 EUR cases / 2,093,175 controls + 22,115 AFR cases / 178,626 controls; 311 EUR and 316 trans-ancestry lead variants, 229 putatively novel; 2 GWS variants in AFR alone |
Multi-ancestry meta-analysis, mixed ICD/self-report/algorithmic phenotypes; looser locus definition than 2022, so counts are not like-for-like |
Overstreet 2026, PMID 42922860 (medRxiv preprint, not peer reviewed) |
| No validated clinical blood, CSF, imaging, EEG or genetic selector |
Cross-domain evidence synthesis |
Ashina 2021, PMID 33773610 |
| Baseline plasma suPAR did not predict erenumab response: OR 0.83 (95% CI 0.64–1.07) |
REFORM prospective cohort, n=623 treated participants |
Karlsson 2025, PMID 40275185 |
| Plasma amylin 9.0 ± 2.3 vs 8.6 ± 1.7 ng/mL in erenumab ≥50% responders vs nonresponders; 9.2 ± 1.7 ng/mL in healthy controls |
REFORM; 100 treated completers and 63 controls; PubMed abstract |
Domínguez-Moreno 2026, PMID 42867283 |
Conflicts that should remain visible
| Apparent conflict |
Resolution |
| Large within-arm MMD reductions vs small placebo-adjusted effects |
Report both; regression, expectation and background care contribute to both arms |
| High drug ranking vs unsuitable individual |
Efficacy ranking does not override contraindication, route, adverse events or access |
| Migraine/stroke association vs prevention of stroke |
Association is not evidence that migraine treatment changes vascular outcomes |
| CGRP-antibody vs onabotulinumtoxinA IS/TIA HR 0.524 (95% CI 0.263–1.046) |
36 events; met a non-inferiority margin but does not establish equivalence or protection (Gül 2026, PMID 42390441) |
| Positive biomarker classifier vs no clinical biomarker |
Development-sample discrimination is not locked multisite clinical validation |
| High pediatric improvement vs no active-drug superiority |
Placebo/context response can be large; compare randomized arms |