Twenty-five years of triptans - a nationwide population study
BACKGROUND: The efficacy of triptans as the main acute treatment strategy for migraine headache at the population-wide level needs to be understood to inform clinical decision-making. We summarise key trends in triptan use using more than 25 years of Danish nationwide data.
METHODS: We conducted a nationwide register-based cohort study based on all Danish residents with access to public healthcare between 1 January 1994 and 31 October 2019 and summarise informative trends of all purchases of triptans in Denmark in the same period. Complete purchase records of Sumatriptan, Naratriptan, Zolmitriptan, Rizatriptan, Almotriptan, Eletriptan, and Frovatriptan were used.
FINDINGS: Over a 25-year period, triptan use increased from 345 to 945 defined daily doses (DDD) per 1000 inhabitants per year and the yearly prevalence of triptan use increased from 5.17 to 14.57 per 1000 inhabitants. Between 2014 and 2019, 12.3% of the Danish migraine population purchased a triptan. Following their initial purchase, 43% of patients had not repurchased triptans within 5 years. At most, 10% of patients indicating triptan discontinuation tried more than one triptan. The prevalence of triptan overuse, defined as having purchased at least 20 DDDs of triptans per month for 3 consecutive months, increased in parallel with the prevalence of triptan use, prevalent in 56 of every 1000 triptan users every year between 2014 and 2019.
INTERPRETATION: In a cohort with access to free clinical consultations and low medication costs, we observed low rates of triptan adherence, likely due to disappointing efficacy and/or unpleasant side effects rather than economic considerations. Triptan success continues to be hindered by poor implementation of clinical guidelines and high rates of treatment discontinuance.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:41 |
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| Enthalten in: |
Cephalalgia : an international journal of headache - 41(2021), 8 vom: 13. Juli, Seite 894-904 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Davidsson, Olafur B [VerfasserIn] |
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| Links: |
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| Themen: |
8R78F6L9VO |
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| Anmerkungen: |
Date Completed 03.12.2021 Date Revised 14.12.2021 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1177/0333102421991809 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM321428544 |
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| 100 | 1 | |a Davidsson, Olafur B |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Twenty-five years of triptans - a nationwide population study |
| 264 | 1 | |c 2021 | |
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| 500 | |a Date Revised 14.12.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: The efficacy of triptans as the main acute treatment strategy for migraine headache at the population-wide level needs to be understood to inform clinical decision-making. We summarise key trends in triptan use using more than 25 years of Danish nationwide data | ||
| 520 | |a METHODS: We conducted a nationwide register-based cohort study based on all Danish residents with access to public healthcare between 1 January 1994 and 31 October 2019 and summarise informative trends of all purchases of triptans in Denmark in the same period. Complete purchase records of Sumatriptan, Naratriptan, Zolmitriptan, Rizatriptan, Almotriptan, Eletriptan, and Frovatriptan were used | ||
| 520 | |a FINDINGS: Over a 25-year period, triptan use increased from 345 to 945 defined daily doses (DDD) per 1000 inhabitants per year and the yearly prevalence of triptan use increased from 5.17 to 14.57 per 1000 inhabitants. Between 2014 and 2019, 12.3% of the Danish migraine population purchased a triptan. Following their initial purchase, 43% of patients had not repurchased triptans within 5 years. At most, 10% of patients indicating triptan discontinuation tried more than one triptan. The prevalence of triptan overuse, defined as having purchased at least 20 DDDs of triptans per month for 3 consecutive months, increased in parallel with the prevalence of triptan use, prevalent in 56 of every 1000 triptan users every year between 2014 and 2019 | ||
| 520 | |a INTERPRETATION: In a cohort with access to free clinical consultations and low medication costs, we observed low rates of triptan adherence, likely due to disappointing efficacy and/or unpleasant side effects rather than economic considerations. Triptan success continues to be hindered by poor implementation of clinical guidelines and high rates of treatment discontinuance | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Migraine | |
| 650 | 4 | |a acute treatment | |
| 650 | 4 | |a nationwide | |
| 650 | 4 | |a population | |
| 650 | 4 | |a triptan | |
| 650 | 7 | |a Serotonin 5-HT1 Receptor Agonists |2 NLM | |
| 650 | 7 | |a Tryptamines |2 NLM | |
| 650 | 7 | |a Sumatriptan |2 NLM | |
| 650 | 7 | |a 8R78F6L9VO |2 NLM | |
| 700 | 1 | |a Olofsson, Isa A |e verfasserin |4 aut | |
| 700 | 1 | |a Kogelman, Lisette Ja |e verfasserin |4 aut | |
| 700 | 1 | |a Andersen, Michael Asger |e verfasserin |4 aut | |
| 700 | 1 | |a Rostgaard, Klaus |e verfasserin |4 aut | |
| 700 | 1 | |a Hjalgrim, Henrik |e verfasserin |4 aut | |
| 700 | 1 | |a Olesen, Jes |e verfasserin |4 aut | |
| 700 | 1 | |a Hansen, Thomas Folkmann |e verfasserin |4 aut | |
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