Study suggests Triptans are the most effective medicine for adults who experience acute migraines
Findings of a study, in which researchers looked at 137 controlled trials that tested oral drugs commonly used to treat migraines, have been published in The British Medical Journal. The trials involved a total of 89,445 patients who were given one of 17 drugs or a placebo.
The paper was led by Professor Andrea Cipriani, Professor of Psychiatry at the University of Oxford and Director of the Oxford Health Clinical Research Facility, along with other researchers across Europe.
The article reports findings from the international AMADEUS (Acute Migraine Attacks: Different Effects of individUal drugS) study, which was funded by the National Institute for Health and Care Research (NIHR) Oxford Health Biomedical Research Centre and the Lundbeck Foundation.
Professor Andrea Cipriani said:
The best performing triptans should be considered as the preferred treatment of choice for migraine episodes owing to their ability to induce rapid and freedom from pain. Our findings pave the way to a precision medicine approach in clinical practice and should be used to help inform future guidelines about treatments for acute migraines to ensure that patients receive the best possible care.”
Triptans are a group of drugs that are often given as an alternative to painkillers if painkillers do not work. Triptans have a different mechanism of action and work by imitating the action of a brain chemical called 5- hydroxytryptamine, also known as serotonin.
Triptans, specifically eletriptan, rizatriptan, sumatriptan and zolmitriptan demonstrated the highest efficacy for pain relief at two hours and sustained pain relief over 24 hours.
Newer drugs, such as lasmiditan, rimegepant and ubrogepant were compared in the study and were found to be comparable to non-steroidal anti-inflammatory drugs (NSAIDs) and paracetamol but were not as effective as triptans.
Ibuprofen also emerged as a strong option for sustained pain freedom up to 24 hours post-dose.
Professor Cipriani added: “Triptans are currently widely underused. Their superior performance of triptans over newer, more expensive, drugs presents a path forward for cost-effective and accessible migraine treatment worldwide.”
Robert Music, chief executive of the Migraine Trust, said: “While triptans can be highly effective for some people with migraine, there are many who do not respond to them. Others experience intolerable side effects or are unable to take them including those with cardiovascular disease. Frequent use of triptans can also lead to medication overuse headache, which exacerbates the problem.
Finding a migraine treatment that works can be incredibly difficult and can take many years of painful trial and error, the consequences of which can lead to loss of employment, impact on finances and significantly reduced mental health.
Our focus should not be deprioritising newer treatments, instead making them more available when people require their use, so that individuals have greater options and choice.”
