Rates and Predictors of Starting a Triptan: Results From the American Migraine Prevalence and Prevention Study

Bigal, Marcelo E.; Buse, Dawn C.; Chen, Ya Ting; Golden, Wendy L.; Serrano, Daniel; Chu, Min Kyung; Lipton, Richard B.

doi:10.1111/j.1526-4610.2010.01703.x

Cited by 21 publications

(27 citation statements)

References 32 publications

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“…New use of triptans is also low in the general population. Results from the "American Migraine Prevalence and Prevention Study" showed that use of triptans is lower in patients aged 60 years, and that moderate and severe disability predicts triptan use [20]. A higher use of triptans during the acute migraine were detected in Spanish migraneurs, although they had a significant lower mean number of migraine attacks.…”

Section: Discussionmentioning

confidence: 98%

Triggers, symptoms, and treatment in two populations of migraneurs in Brazil and Spain. A cross-cultural study

Carod-Artal¹,

Ezpeleta²,

Martín-Barriga³

et al. 2011

Journal of the Neurological Sciences

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Section: Discussionmentioning

confidence: 98%

Triggers, symptoms, and treatment in two populations of migraneurs in Brazil and Spain. A cross-cultural study

Carod-Artal¹,

Ezpeleta²,

Martín-Barriga³

et al. 2011

Journal of the Neurological Sciences

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“…Prior population studies show that 20% of persons with migraine used acute prescription medications for treatment 18 . In a study of AMPP participant data from the 2005 survey, 20.3% of individuals with migraine used triptans 19 …”

Section: Discussionmentioning

confidence: 99%

“…Among participations who had recently consulted a health care professional for headache and had ever received a diagnosis, predictors of using an appropriate acute treatment included household income, MIDAS scores, and the MSSS. Another analyses of the 2005 AMPP database found that younger age, higher household income, having health insurance, higher headache‐related disability, and use of preventive medications predicted triptan use 19 . For persons with unmet need, despite appropriate acute treatment, a more comprehensive approach to management is required.…”

Section: Discussionmentioning

confidence: 99%

Barriers to the Diagnosis and Treatment of Migraine: Effects of Sex, Income, and Headache Features

et al. 2012

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Among persons with migraine in need of medical care (MIDAS Grade II or greater), only one quarter traversed the 3 steps we proposed to be necessary to achieving minimally appropriate care (consulting, diagnosis, and treatment/medication use). Health insurance status was an important predictor of consulting. Among consulters, women were far more likely to be diagnosed than men, suggesting that gender bias in diagnosis may be an important barrier for men. There were economic barriers related to use of appropriate prescription medications. Public health efforts should focus on improving consultation rates, particularly in the uninsured and diagnostic rates particularly in males with migraine.

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“…Headache specialists usually prefer to treat acute attacks of migraine with a migraine‐specific medication with the dose and route of administration that has a great likelihood of success for that particular patient. Triptans are currently the preferred class of medication prescribed for this aim . They are effective medications, available in many dosage forms and many are now generic; but, among patients receiving triptans, upwards of 40% do not have optimal responses and 20‐30% of them develop a recurrent migraine attack requiring either re‐dosing or a rescue medication .…”

Section: Clinical Implications Of Future Cgrp‐related Medicationsmentioning

confidence: 99%

Calcitonin Gene‐Related Peptide (CGRP) and Migraine Current Understanding and State of Development

2013

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Calcitonin gene-related peptide (CGRP) is a ubiquitous neuropeptide found at the very centers of the migraine process, both centrally and peripherally. It has been under careful study for approximately 25 years. Several CGRP-receptor antagonists are being evaluated for acute treatment of episodic migraine. Three monoclonal antibodies are being studied for prevention of episodic migraine, and 1 monoclonal antibody is being studied for prevention of chronic migraine. In this review, we discuss the role of CGRP in normal physiology and the consequences of CGRP inhibition for human homeostasis. We then review the current state of development for CGRP-receptor antagonists and CGRP monoclonal antibodies. We close by speculating on the potential clinical role of CGRP antagonism in the acute and preventive treatment of episodic and chronic migraine.Key words: calcitonin gene-related peptide, antibodies, migraine, chronic migraine (Headache 2013;53:1230-1244 Calcitonin gene-related peptide (CGRP) is a 37-amino-acid neuropeptide that is derived from the gene encoding calcitonin by alternative splicing of mRNA and proteolytic processing of its precursor. 1,2Despite their common origin, calcitonin and CGRP are involved in totally different physiological processes in humans. While calcitonin is mainly related to calcium homeostasis and bone remodeling, CGRP is involved in vasodilation and sensory transmission.CGRP is found in literally every organ system in the body, 3 occurring in 2 isoforms, a-and b-CGRP. 4,5a-CGRP is the predominant form in the peripheral nervous system, while the b-isoform is mainly present in the enteric nervous system. 6 CGRP is highly conserved across species, 7 suggesting that the neuropeptide is of importance in functions that were established relatively early in mammalian evolution.Immunohistochemistry demonstrated that CGRP is mainly produced in the cell bodies of both ventral and dorsal root neurons.8 Radioimmunology further demonstrated that this molecule is especially common in the trigeminal system, where up to 50% of the neurons produce it.9 Indeed, the potential role of CGRP in migraine pathophysiology was suggested more than 20 years ago, 10,11 and since then, our knowledge of the peptide and its role in the pathophysiology of migraine has increased substantially and has

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Rates and Predictors of Starting a Triptan: Results From the American Migraine Prevalence and Prevention Study

Abstract: New use of triptans is low in the population. Because adequacy of care was not assessed, future studies should focus on investigating whether this low rate of triptan start is proper or if it reflects an unmet treatment need.

Cited by 21 publications

References 32 publications

Triggers, symptoms, and treatment in two populations of migraneurs in Brazil and Spain. A cross-cultural study

Triggers, symptoms, and treatment in two populations of migraneurs in Brazil and Spain. A cross-cultural study

Barriers to the Diagnosis and Treatment of Migraine: Effects of Sex, Income, and Headache Features

Calcitonin Gene‐Related Peptide (CGRP) and Migraine Current Understanding and State of Development

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