Study Finds Unmet Medical Need in Triptan-Treated Migraines

Migraine affects many individuals worldwide, yet many patients remain undiagnosed or undertreated, highlighting a widespread, unmet need that calls for new drugs and pathways for migraine treatment, according to a study published by The Journal of Headache and Pain.

The study involved a 2-year longitudinal analysis of patients with migraine using triptan treatments who had unmet medical needs. The subjects considered in this study were collected from a pharmaceutical database and received at least 1 triptan prescription during 2013; following the first prescription date, there were 24-months of observational periods.

“Acute therapy of migraine attacks consists of triptans, ergot derivatives, and analgesics (NSAIDs) to which an antiemetic can be added,” the authors explained. “It has become essential to know the real-life burden of unmet medical needs (UMN) in migraine, by distinguishing between migraine with “high” medical needs and migraine with “low” medical needs.”

The sample included individuals with 4 or more triptan dose units per month, who were then separated into categories based on their prescribed doses: possible Low-Frequency Episodic Migraine, possible High-Frequency Episodic Migraine, and possible Chronic Migraine. The first-year follow-up focused on the use of preventative therapies, while the second analyzed the reduction in triptan use.

The researchers found that 8 per 1000 people, of the 10,270,683 patients considered, were triptan users. Of triptan users, 38.2% suffered from migraines and had unmet medical needs. Additionally, 19.1% of individuals were using oral preventative drugs. During the follow-up period, 22.3% of individuals were found to reduce triptan use, which decreased with the intensification of need levels, according to the researchers.

“These findings reveal that in the group of migraineurs receiving triptans (a therapy generally subsequent to a correct diagnosis by neurologists) there is still a large part of migraineurs without sufficient relief of their condition,” noted the authors. “Moreover, the showed distribution of different need levels should be taken into account to estimate the rate of migraine sufferers who can benefit more from new therapies.”

The study results demonstrates that there may be a need for more effective preventive strategies as there continues to be an unmet medical need for patients with migraine. This data could help in the development of new pathways for migraine that aim to improve patient outcomes.

“In view of the new drugs being introduced for the prevention of migraine this study could represent a model to design future studies aimed to analyse appropriateness in the management of migraine and to help policy decision makers in the resource allocation for this disease,” concluded the researchers.

Reference

Piccinni C, Cevoli S, Ronconi G, et al. A real-world study on unmet medical needs in triptan-treated migraine: prevalence, preventive therapies and triptan use modification from a large Italian population along two years [published online June 27, 2019]. J Headache Pain. doi: 10.1186/s10194-019-1027-7.