Kawata AK, Shah N, Poon JL, et al. - In patients with migraine who initiated preventive migraine medications prior to the introduction of calcitonin gene‐related peptide inhibitors in the US, this study was sought to define the burden, unmet need, and treatment patterns. In a real‐world observational study using a prospective cohort design, researchers included episodic (EM) and chronic migraine (CM) patients starting or changing preventive treatment at primary care or neurology clinic visits in the US between March 2016 and October 2017. For a descriptive analysis of migraine patient experience and treatment patterns, data on migraine frequency, treatment modifications, migraine impact on functioning, and work productivity were obtained from study sites and patients at baseline and then monthly for 6 months. Among 234 participants, 118 had EM (50.4%) and 116 had CM (49.6%). Before 2018, for patients initiating preventive treatments, the burden of migraine was high. The data demonstrated that the preventive treatments used in this research were poorly tolerated and had poor efficacy, resulting in poor adherence. It has been reported that the high discontinuation rates imply that the preventive medications being offered during the period of the study did not meet the treatment needs of patients. The data imply the requirement for more effective and better tolerated preventive treatment options.