Triptan use in Australia 1997-2015: A pharmacoepidemiological study

Eyre, Beth; Eadie, Mervyn J.; Driel, Mieke van; Ross-Lee, Lesley; Hollingworth, Samantha

doi:10.1111/ane.12727

Cited by 3 publications

(5 citation statements)

References 20 publications

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“…A similar strategy was used by another Italian study [26] based on electronic health records of general practitioners and obtaining results comparable to ours. Moreover, to date, several studies used healthcare databases to investigate the use of triptans, both concerning Italian settings [27, 28] and other countries, such as France, the Netherlands, Germany and Australia [29–32]. Nevertheless, no epidemiological data were derived from these data sources on the real-life UMN in migraine, which represents an important issue in the neurological field.…”

Section: Discussionmentioning

confidence: 99%

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

Piccinni¹,

Cevoli

Ronconi³

et al. 2019

J Headache Pain

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BackgroundAlthough migraine is a disabling neurological condition that causes important disability, it remains an area of underdiagnosis and undertreatment worldwide. The aim of this study was to depict the burden of the unmet medical needs in migraine treated with triptans in a large Italian population.MethodsA 2-year longitudinal analysis of migraineurs with unmet medical needs on treatment with triptans was performed. The studied cohort consisted of subjects with ≥4 triptan dose units per month, selected from the general population These patients were stratified into: possible Low-Frequency Episodic Migraine (pLF-EM: 4–9 triptan dose units per month), possible High-Frequency Episodic Migraine (pHF-EM: 10–14 triptan dose units per month) and possible Chronic Migraine (pCM:> 14 triptan dose units per month). The first follow-up year was analysed to describe the use of preventive therapies, the second year to describe the ≥50% reduction in triptan use.ResultsOf 10,270,683 adults, 8.0 per 1000 were triptan users and, of these, 38.2% were migraineurs with unmet medical needs, corresponding to 3.1 per 1000 adults. By stratifying for the number of triptan dose units per month, 72.3% were affected by pLF-EM, 17.4% by pHF-EM, and 10.3% by pCM. In this cohort, 19.1% of individuals used oral preventive drugs and 0.1% botulinum toxin. Triptan use reduction was found in 22.3% individuals of the cohort, decreasing with the intensification of need levels (25.8% pLF-EM, 13.6% pHF-EM, 12.0% pCM).ConclusionsThis real-life analysis underlined that the unmet medical needs concern a large part of patients treated with triptans and there is an undertreatment with preventive therapies whose benefit is insufficient, which may be due to the lack of effective preventive strategies, probably still reserved to severe patients. This study allows forecasting the actual impact of newest therapeutic strategies aimed to fill this gap.

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Section: Discussionmentioning

confidence: 99%

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

Piccinni¹,

Cevoli

Ronconi³

et al. 2019

J Headache Pain

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“…An Australian pharmacoepidemiological study showed that total triptan use has increased at an average annual rate of 112% over the 18-year period. 22 Besides, only a minority of migraine patients use the specific antimigraine drug triptans (10% in Denmark, 17% in Italy, and 35% in France). 23 – 25 The most probable reason is the relatively low efficacy.…”

Section: Current Acute Treatmentsmentioning

confidence: 99%

Serotonin receptor agonists in the acute treatment of migraine: a review on their therapeutic potential

Negro¹,

Koverech

Martelletti³

2018

JPR

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Migraine is an important socioeconomic burden and is ranked the sixth cause of years of life lost because of disability in the general population and the third cause of years of life lost in people younger than 50 years. The cornerstone of pharmacological treatment is represented by the acute therapy. The serotonin (5-hydroxytryptamine [5-HT]) receptor subtype 1B/1D agonists, called triptans, are nowadays the first-line acute therapy for patients who experience moderate-to-severe migraine attacks. Unfortunately, a high percentage of patients are not satisfied with this acute treatment, either for lack of response or side effects. Moreover, their mechanism of action based on vasoconstriction makes them unsuitable for patients with previous cardio- and cerebrovascular diseases and for those with uncontrolled hypertension. Since the introduction of triptans, no other acute drug class has passed all developmental stages. The research for a new drug lacking vasoconstrictive effects led to the development of lasmiditan, a highly selective 5-HT1F receptor agonist with minimized interactions with other 5-HT receptor subtypes. Lasmiditan is considered to be the first member of a new drug category, the neurally acting anti-migraine agent (NAAMA). Phase II and III trials had shown superiority compared to placebo and absence of typical triptan-associated adverse events (AEs). Most of the AEs were related to the central nervous system, depending on the high permeability through the blood–brain barrier and mild to moderate severity. The results of ongoing long-term Phase III trials will determine whether lasmiditan will become available in the market, and then active triptan comparator studies will assess patients’ preference. Future studies could then explore the safety during pregnancy and breastfeeding or the risk that overuse of lasmiditan leads to medication overuse headache.

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“…The debate revolved around safety, efficacy, consistency, drugdrug interactions with prophylactic drugs, pharmacokinetics/ pharmacodynamics, new delivery pathways, extension of this pharmacological class to the population aged under 18 or over 65 years, evaluation of common adverse events, disability levels [6][7][8][9][10][11][12]. Notwithstanding, only 27% of migraine patients receive a correct diagnosis and only 17% of them takes triptans for a crisis [13,14]. Therefore, two different studies in Italy and Australia show how in a real population of migraine patients only the great minority of them receive a correct advice for the treatment of the crisis [13,14].…”

Section: Travelling From Nsaids To Triptans To Cgrpmentioning

confidence: 99%

“…Notwithstanding, only 27% of migraine patients receive a correct diagnosis and only 17% of them takes triptans for a crisis [13,14]. Therefore, two different studies in Italy and Australia show how in a real population of migraine patients only the great minority of them receive a correct advice for the treatment of the crisis [13,14].…”

Section: Travelling From Nsaids To Triptans To Cgrpmentioning

confidence: 99%

“…The ideal migraine treatment is still far, and it seems that there is not a resolved trend to cover the needs of 83% migraine patients never treated with triptans [13,14]. Precision medicine applied to migraine shows structural weaknesses, based on the variety of the genes involved and the well-known multifactorial nature of migraine itself [19,20].…”

Section: Meanwhile Acute Migraine Treatment Loses Groundmentioning

confidence: 99%

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