Few With Acute Migraine Take Triptans, Many Discontinue the Drug

Woman using nasal spray
Woman using nasal spray
Few patients were found to take triptan medications to treat acute migraine, and a majority of those who had, discontinued the treatment due to side effects.

The following article is part of conference coverage from the PAINWeek 2018 conference in Las Vegas, Nevada. Clinical Pain Advisor’s staff will be reporting breaking news associated with research conducted by leading experts in pain medicine. Check back for the latest news from PAINWeek 2018.

LAS VEGAS —Few patients were found to take triptan medications to treat acute migraine, and a majority of those who had, discontinued the treatment due to side effects, according to a study presented during the 2018 PAINWeek conference, held September 4-8.

Investigators sought to determine patterns of medication use in patients with acute migraine, specifically past and current triptan use (via oral, injectable, and nasal routes of administration), and the reasons for discontinuation.

The study included 15,133 participants, ≥18 years (median monthly headache frequency, 3.3 days a month), who reported using prescription medications to treat acute migraine. A survey questionnaire was used to collect information regarding past and current triptan use as well as reasons for discontinuing triptan medications. Route of triptan administration was provided in descriptive terms, and a pre-coded list was used to identify side effects from triptan use.

A total of 5596 study participants (37%) reported ever using triptan, with 1241 patients (8.2%) who had used more than one route of triptan administration and 272 patients (1.8%) who had used all 3 therapeutic modes of administration (oral, nasal spray, and injectable). Of all study participants, 2421 respondents were currently using triptan (84.7% used oral medications, 16.5% used nasal spray, and 8.1% used an injectable form of triptan). Of participants currently taking triptan medications, 9.3% were using multiple routes of administration. Discontinuation was highest in patients taking injectable triptan (81.5%), followed by patients using nasal sprays (66.5%), and by patients who were taking oral triptan medications (55.2%). Reasons for discontinuation included a perceived lack of efficacy (oral, 38.4%; nasal spray, 39.8%; injectable triptan, 25.7%), and side effects (oral, 22.8%; nasal spray, 17%; injectable triptan, 20.6%). The most common side effects reported were dizziness, nausea, and fatigue.

”Among ever triptan users, 56.7% have discontinued use, indicating substantial unmet medical needs,” noted the study investigators.

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Alam A, Munjal S, Reed M, et al. Triptan use and discontinuation in a representative sample of persons with migraine: results from migraine in American symptoms and treatment (MAST) study. Poster 3. Presented at: 2018 PAINWeek; September 4–8, 2018; Las Vegas, NV.

For more coverage of PAINWeek 2018, click here.