Triptans are first-line for migraine pain, but are patients using them?

  • Lipton RB & al.
  • Cephalalgia
  • 5 Mar 2020

  • curated by Kelli Whitlock Burton
  • Clinical Essentials
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Takeaway

  • More than half of patients with migraine who were prescribed a first-line triptan for treatment did not refill their prescription within 12 months.
  • Among those who did not refill their initial triptan prescription, more than half filled ≥1 opioid prescription in 24 months of follow-up and one-third filled a prescription for NSAIDs.

Why this matters

  • Triptans are the standard recommended first-line treatment for moderate or severe migraines.

Study design

  • Study of 10,509 patients (age ≥18 years) with ≥1 triptan prescription during 2013.
  • Funding: Allergan, plc., Dublin, Ireland.

Key results

  • 50.8% and 43.6% patients had no triptan refills over the 12 and 24 months, respectively.
  • At 12- and 24-month postindex, respectively:
    • 90.5% and 86.1% used 1 type of triptan;
    • 8.4% and 12.0% used 2 different triptans; 
    • 1.0% and 2.0% used ≥3 different triptans.  
  • Among patients with no refill, commonly used acute medications:
    • Opioids (39%) and NSAIDs (22%) at 12 months;
    • Opioid (53%), NSAID (33%) at 24 months.
  • At 24 months, patients with and without a triptan refill had similar use of:
    • Opioids (39% vs 42%);
    • NSAIDs (22% vs 22%);
    • Butalbital (9% vs 10%).

Limitations

  • Retrospective study design.

Coauthored with Vijay Rathod, PhD.