InterMiG: international differences in the therapeutic approach to migraine patients in specialized headache centers.
J Headache Pain
; 22(1): 43, 2021 May 24.
Article
em En
| MEDLINE
| ID: mdl-34030634
ABSTRACT
BACKGROUND:
There is currently a wide therapeutic arsenal for migraine patients, without a single first-line preventive drug and we choose the different available alternatives taking into account comorbidities, national guidelines, previous treatments and personal experiences. Our objective was to evaluate the differences in the use of migraine treatments between neurologists from different countries.METHODS:
This is a multi-centre observational study carried out by neurologists from specialized headache units in seven countries, retrospective with consecutive inclusion of all patients presenting with a migraine diagnosis, over a period of three months.RESULTS:
A total of 734 patients were recruited but only 600 were considered in the analysis in order to homogenize the patient cohorts from countries 200 Spain (ES), 100 Italy (IT), 85 Russia (RUS), 80 Germany (DE), 60 Portugal (PT), 45 Poland (PL) and 30 Australia (AU). 85.4 % of patients were women with a mean age of 42.6 ± 11.8 years. Considering previous and current preventive treatment, the order of use was antidepressants (69.3 %), antiepileptic drugs (54.7 %), beta-blockers and antihypertensive drugs (49.7 %), OnabotulinumtoxinA (44.0 %) and others (36.2 %). Statistically significant differences were found between all pharmacological classes antidepressants were commonly used in all countries, with the exception of Poland (AU 76.7 %, IT 71.0 %, DE 60.0 %, PL 31.1 %, PT 71.7 %, RUS 70.6 %, ES 78.5 %; p < 0.0001); antiepileptic drugs were more frequently prescribed in Portugal, Australia and Spain (AU 73.3 %, IT 40.0 %, DE 37.5 %, PL 48.9 %, PT 85.0 %, RUS 29.4 % and ES 69.0 %; p < 0.0001); beta-blockers and antihypertensive drugs were frequently used in all countries except Italy (AU 60.0 %, IT 14.0 %, DE 53.8 %, PL 48.9 %, PT 68.3 %, RUS 49.4 % and ES 59.0 %; p < 0.0001); BTX-A were predominately used in Spain, Italy and Australia (AU56.7 %, IT58.0 %, DE20.0 %, PL 42.2 %, PT 26.7 %, RUS 24.7 % and ES 58.5 %; p < 0.0001) and others were most frequently used in Poland (AU 0.0 %, IT 19.0 %, DE 42.5 %, PL 95.6 %, PT 31.7 %, RUS 3.5 % and ES 49.5 %; p < 0.0001). If only patients without comorbidities are considered (200/600), statistically differences between countries persist in all preventive treatments.CONCLUSIONS:
There is heterogeneity in the choice of preventive treatment between different countries. Prospective comparative studies of the different oral and subcutaneous alternatives would help to create a global therapeutic algorithm that would guarantee the best option for our patients.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Transtornos de Enxaqueca
Tipo de estudo:
Guideline
/
Observational_studies
/
Risk_factors_studies
Limite:
Adult
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Female
/
Humans
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Male
/
Middle aged
País/Região como assunto:
Europa
/
Oceania
Idioma:
En
Revista:
J Headache Pain
Assunto da revista:
MEDICINA INTERNA
/
NEUROLOGIA
/
PSICOFISIOLOGIA
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Espanha