Triptan non-response in specialized headache care : cross-sectional data from the DMKG Headache Registry
© 2023. Springer-Verlag Italia S.r.l., part of Springer Nature..
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).
| Errataetall: |
CommentIn: MMW Fortschr Med. 2024 Apr;166(6):26. - PMID 38581504 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:24 |
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| Enthalten in: |
The journal of headache and pain - 24(2023), 1 vom: 10. Okt., Seite 135 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Ruscheweyh, Ruth [VerfasserIn] |
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| Links: |
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| Themen: |
Acute headache treatment |
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| Anmerkungen: |
Date Completed 12.10.2023 Date Revised 08.04.2024 published: Electronic CommentIn: MMW Fortschr Med. 2024 Apr;166(6):26. - PMID 38581504 Citation Status MEDLINE |
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| doi: |
10.1186/s10194-023-01676-0 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 500 | |a CommentIn: MMW Fortschr Med. 2024 Apr;166(6):26. - PMID 38581504 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023. Springer-Verlag Italia S.r.l., part of Springer Nature. | ||
| 520 | |a 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' | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 520 | |a TRIAL REGISTRATION: The DMKG Headache Registry is registered with the German Clinical Trials Register (DRKS 00021081) | ||
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| 700 | 1 | |a Freilinger, Tobias |e verfasserin |4 aut | |
| 700 | 1 | |a Förderreuther, Stefanie |e verfasserin |4 aut | |
| 700 | 1 | |a Gaul, Charly |e verfasserin |4 aut | |
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| 700 | 1 | |a Jürgens, Tim Patrick |e verfasserin |4 aut | |
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