Triptan non-response in specialized headache care: cross-sectional data from the DMKG Headache Registry.
J Headache Pain
; 24(1): 135, 2023 Oct 10.
Article
in En
| MEDLINE
| ID: mdl-37817093
ABSTRACT
BACKGROUND:
Triptans are effective for many migraine patients, but some do not experience adequate efficacy and tolerability. The European Headache Federation (EHF) has proposed that patients with lack of efficacy and/or tolerability of ≥ 2 triptans ('triptan resistance') could be considered eligible for treatment with the novel medications from the ditan and gepant groups. There is little data on the frequency of 'triptan resistance'.METHODS:
We used patient self-report data from the German Migraine and Headache Society (DMKG) Headache Registry to assess triptan response and triptan efficacy and/or tolerability failure.RESULTS:
A total of 2284 adult migraine patients (females 85.4%, age 39.4 ± 12.8 years) were included. 42.5% (n = 970) had failed ≥ 1 triptan, 13.1% (n = 300) had failed ≥ 2 triptans (meeting the EHF definition of 'triptan resistance'), and 3.9% (n = 88) had failed ≥ 3 triptans. Compared to triptan responders (current use, no failure, n = 597), triptan non-responders had significantly more severe migraine (higher frequency (p < 0.001), intensity (p < 0.05), and disability (p < 0.001)), that further increased with the level of triptan failure. Responders rates were highest for nasal and oral zolmitriptan, oral eletriptan and subcutaneous sumatriptan.CONCLUSION:
In the present setting (specialized headache care in Germany), 13.1% of the patients had failed ≥ 2 triptans. Triptan failure was associated with increased migraine severity and disability, emphasizing the importance of establishing an effective and tolerable acute migraine medication. Acute treatment optimization might include switching to one of the triptans with the highest responder rates and/or to a different acute medication class. TRIAL REGISTRATION The DMKG Headache Registry is registered with the German Clinical Trials Register (DRKS 00021081).Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Headache
/
Migraine Disorders
Type of study:
Observational_studies
/
Prevalence_studies
/
Risk_factors_studies
Limits:
Adult
/
Female
/
Humans
/
Middle aged
Language:
En
Journal:
J Headache Pain
Journal subject:
MEDICINA INTERNA
/
NEUROLOGIA
/
PSICOFISIOLOGIA
Year:
2023
Type:
Article
Affiliation country:
Germany