Skip to main content
Top

Open Access 27-03-2024 | Triptan Drugs | Original Article

Acute treatment of migraine: quantifying the unmet need through real-world data in Italy

Authors: Simona Sacco, Sonia Di Ciaccio, Roberto Di Virgilio, Valeria Pegoraro, Raffaele Ornello

Published in: Neurological Sciences

Login to get access

Abstract

Objective

This study is describing subjects with migraine interrupting or not receiving triptans for acute treatment and providing a national-level estimate of people who might benefit from different therapeutic approaches.

Methods

This is a retrospective analysis using IQVIA Longitudinal Patient Database. Starting from 18 + years old individuals with migraine, we selected two cohorts: subjects with triptans prescriptions before and no triptans prescriptions after Index Date (triptan withdraw) and subjects without triptans prescriptions both before and after Index Date (no triptan prescriptions). Index Date was the first record of a health encounter for migraine in 2019. Individuals with cardiovascular disease (CVD) within no triptan prescriptions group were also quantified.

Results

Triptan withdraw and no triptan prescriptions cohorts numbered 605 and 3270, respectively, 5% and 29% of subjects with migraine. Mean age was 47 and 51 years respectively; women were more represented (~ 80%). Hypertension and thyroid disease were most frequent comorbidities; non-steroidal anti-inflammatory drugs were among most frequently recorded treatments. Subjects with CVD within no triptan prescriptions cohort were 621 and with triptan withdraw cohort subjects represented the basis to estimate those who might benefit from alternative options for the acute treatment of migraine, who were around 60,000 and accounted for 11% of subjects seeking primary care due to migraine.

Conclusions

This analysis provides a real-word estimate of Italian people that might benefit from different therapeutic approaches as an alternative to triptans, which sometimes might be not effective and/or poorly tolerated. Such estimate should be intended as the lower limit of a wider range due to strict criteria adopted.
Appendix
Available only for authorised users
Literature
1.
go back to reference McLean G, Mercer SW (2017) Chronic migraine, comorbidity, and socioeconomic deprivation: cross-sectional analysis of a large nationally representative primary care database. J Comorbidity 7:89–95CrossRef McLean G, Mercer SW (2017) Chronic migraine, comorbidity, and socioeconomic deprivation: cross-sectional analysis of a large nationally representative primary care database. J Comorbidity 7:89–95CrossRef
2.
go back to reference Snoer AH, Høst C, Dømgaard M, Hansen JM (2021) Frequent or chronic migraine negatively impacts personal, social and professional life. Dan Med J 68:A08200592PubMed Snoer AH, Høst C, Dømgaard M, Hansen JM (2021) Frequent or chronic migraine negatively impacts personal, social and professional life. Dan Med J 68:A08200592PubMed
3.
go back to reference Steiner TJ, Stovner LJ, Jensen R, Uluduz D, Katsarava Z; On behalf of Lifting The Burden: the Global Campaign against Headache (2020) Migraine remains second among the world’s causes of disability, and first among young women: findings from GBD2019. J Headache Pain 21(1):137. https://doi.org/10.1186/s10194-020-01208-0 Steiner TJ, Stovner LJ, Jensen R, Uluduz D, Katsarava Z; On behalf of Lifting The Burden: the Global Campaign against Headache (2020) Migraine remains second among the world’s causes of disability, and first among young women: findings from GBD2019. J Headache Pain 21(1):137. https://​doi.​org/​10.​1186/​s10194-020-01208-0
4.
go back to reference Adams AM et al (2015) The impact of chronic migraine: The Chronic Migraine Epidemiology and Outcomes (CaMEO) Study methods and baseline results. Cephalalgia 35:563–578CrossRefPubMedPubMedCentral Adams AM et al (2015) The impact of chronic migraine: The Chronic Migraine Epidemiology and Outcomes (CaMEO) Study methods and baseline results. Cephalalgia 35:563–578CrossRefPubMedPubMedCentral
5.
go back to reference Martelletti P et al (2021) Healthcare resource use and indirect costs associated with migraine in Italy: results from the My Migraine Voice survey. J Med Econ 24:717–726CrossRefPubMed Martelletti P et al (2021) Healthcare resource use and indirect costs associated with migraine in Italy: results from the My Migraine Voice survey. J Med Econ 24:717–726CrossRefPubMed
6.
go back to reference Agostoni E et al (2019) Real-world insights on the management of migraine patients: an Italian nationwide study. Curr Med Res Opin 35:1545–1554CrossRefPubMed Agostoni E et al (2019) Real-world insights on the management of migraine patients: an Italian nationwide study. Curr Med Res Opin 35:1545–1554CrossRefPubMed
7.
go back to reference de Boer I, Verhagen IE, Souza MNP, Ashina M (2023) Place of next generation acute migraine specific treatments among triptans, non-responders and contraindications to triptans and possible combination therapies. Cephalalgia 43:033310242211437CrossRef de Boer I, Verhagen IE, Souza MNP, Ashina M (2023) Place of next generation acute migraine specific treatments among triptans, non-responders and contraindications to triptans and possible combination therapies. Cephalalgia 43:033310242211437CrossRef
8.
go back to reference Sacco S et al (2022) European Headache Federation (EHF) consensus on the definition of effective treatment of a migraine attack and of triptan failure. J Headache Pain 23:133CrossRefPubMedPubMedCentral Sacco S et al (2022) European Headache Federation (EHF) consensus on the definition of effective treatment of a migraine attack and of triptan failure. J Headache Pain 23:133CrossRefPubMedPubMedCentral
9.
go back to reference Leroux E et al (2020) Evaluation of patients with insufficient efficacy and/or tolerability to triptans for the acute treatment of migraine: a systematic literature review. Adv Ther 37:4765–4796CrossRefPubMedPubMedCentral Leroux E et al (2020) Evaluation of patients with insufficient efficacy and/or tolerability to triptans for the acute treatment of migraine: a systematic literature review. Adv Ther 37:4765–4796CrossRefPubMedPubMedCentral
11.
go back to reference Di Marco F et al (2017) Characteristics of newly diagnosed COPD patients treated with triple inhaled therapy by general practitioners: a real world Italian study. NPJ Prim Care Respir Med 27:51CrossRefPubMedPubMedCentral Di Marco F et al (2017) Characteristics of newly diagnosed COPD patients treated with triple inhaled therapy by general practitioners: a real world Italian study. NPJ Prim Care Respir Med 27:51CrossRefPubMedPubMedCentral
13.
go back to reference Volpe M, Pegoraro V, Peduto I, Heiman F, Meto S (2022) Extemporaneous combination therapy with nebivolol/zofenopril in hypertensive patients: usage in Italy. Curr Med Res Opin 38:1673–1681CrossRefPubMed Volpe M, Pegoraro V, Peduto I, Heiman F, Meto S (2022) Extemporaneous combination therapy with nebivolol/zofenopril in hypertensive patients: usage in Italy. Curr Med Res Opin 38:1673–1681CrossRefPubMed
14.
go back to reference Di Nicola M et al (2023) Adherence to, and persistence of, antidepressant therapy in patients with major depressive disorder: results from a population-based study in Italy. Curr Neuropharmacol 21:727–739CrossRefPubMedPubMedCentral Di Nicola M et al (2023) Adherence to, and persistence of, antidepressant therapy in patients with major depressive disorder: results from a population-based study in Italy. Curr Neuropharmacol 21:727–739CrossRefPubMedPubMedCentral
15.
go back to reference Katz P, Pegoraro V, Liedgens H (2017) Characteristics, resource utilization and safety profile of patients prescribed with neuropathic pain treatments: a real-world evidence study on general practices in Europe - the role of the lidocaine 5% medicated plaster. Curr Med Res Opin 33:1481–1489CrossRefPubMed Katz P, Pegoraro V, Liedgens H (2017) Characteristics, resource utilization and safety profile of patients prescribed with neuropathic pain treatments: a real-world evidence study on general practices in Europe - the role of the lidocaine 5% medicated plaster. Curr Med Res Opin 33:1481–1489CrossRefPubMed
16.
go back to reference Padovani A, Falato S, Pegoraro V (2023) Extemporaneous combination of donepezil and memantine to treat dementia in Alzheimer disease: evidence from Italian real-world data. Curr Med Res Opin 39:567–577CrossRefPubMed Padovani A, Falato S, Pegoraro V (2023) Extemporaneous combination of donepezil and memantine to treat dementia in Alzheimer disease: evidence from Italian real-world data. Curr Med Res Opin 39:567–577CrossRefPubMed
17.
go back to reference Dodick DW et al (2020) Migraine patients with cardiovascular disease and contraindications: an analysis of real-world claims data. J Prim Care Community Health 11:215013272096368CrossRef Dodick DW et al (2020) Migraine patients with cardiovascular disease and contraindications: an analysis of real-world claims data. J Prim Care Community Health 11:215013272096368CrossRef
19.
go back to reference Mathew NT et al (2009) Fixed-dose sumatriptan and naproxen in poor responders to triptans with a short half-life. Headache J Head Face Pain 49:971–982CrossRef Mathew NT et al (2009) Fixed-dose sumatriptan and naproxen in poor responders to triptans with a short half-life. Headache J Head Face Pain 49:971–982CrossRef
20.
go back to reference Panconesi A, Pavone E, Vacca F, Vaiani M, Banfi R (2008) Triptans in the Italian population: a drug utilization study and a literature review. J Headache Pain 9:71–76CrossRefPubMedPubMedCentral Panconesi A, Pavone E, Vacca F, Vaiani M, Banfi R (2008) Triptans in the Italian population: a drug utilization study and a literature review. J Headache Pain 9:71–76CrossRefPubMedPubMedCentral
22.
go back to reference Pavone E, Banfi R, Vaiani M, Panconesi A (2007) Patterns of triptans use: a study based on the records of a community pharmaceutical department. Cephalalgia Int J Headache 27:1000–1004CrossRef Pavone E, Banfi R, Vaiani M, Panconesi A (2007) Patterns of triptans use: a study based on the records of a community pharmaceutical department. Cephalalgia Int J Headache 27:1000–1004CrossRef
23.
go back to reference Deighton AM et al (2021) The burden of medication overuse headache and patterns of switching and discontinuation among triptan users: a systematic literature review. BMC Neurol 21:425CrossRefPubMedPubMedCentral Deighton AM et al (2021) The burden of medication overuse headache and patterns of switching and discontinuation among triptan users: a systematic literature review. BMC Neurol 21:425CrossRefPubMedPubMedCentral
24.
go back to reference Orlando V, Mucherino S, Monetti VM, Trama U, Menditto E (2020) Treatment patterns and medication adherence among newly diagnosed patients with migraine: a drug utilisation study. BMJ Open 10:e038972CrossRefPubMedPubMedCentral Orlando V, Mucherino S, Monetti VM, Trama U, Menditto E (2020) Treatment patterns and medication adherence among newly diagnosed patients with migraine: a drug utilisation study. BMJ Open 10:e038972CrossRefPubMedPubMedCentral
25.
go back to reference Piccinni C et al (2019) A real-world study on unmet medical needs in triptan-treated migraine: prevalence, preventive therapies and triptan use modification from a large Italian population along two years. J Headache Pain 20:74CrossRefPubMedPubMedCentral Piccinni C et al (2019) A real-world study on unmet medical needs in triptan-treated migraine: prevalence, preventive therapies and triptan use modification from a large Italian population along two years. J Headache Pain 20:74CrossRefPubMedPubMedCentral
26.
go back to reference Stewart W, Wood C, Reed M, Roy J, Lipton R (2008) Cumulative lifetime migraine incidence in women and men. Cephalalgia 28:1170–1178CrossRefPubMed Stewart W, Wood C, Reed M, Roy J, Lipton R (2008) Cumulative lifetime migraine incidence in women and men. Cephalalgia 28:1170–1178CrossRefPubMed
28.
go back to reference Lipton RB et al (2007) Migraine prevalence, disease burden, and the need for preventive therapy. Neurology 68:343–349CrossRefPubMed Lipton RB et al (2007) Migraine prevalence, disease burden, and the need for preventive therapy. Neurology 68:343–349CrossRefPubMed
29.
go back to reference Zhang J et al (2023) Association between migraine or severe headache and hypertension among US adults: a cross-sectional study. Nutr Metab Cardiovasc Dis NMCD 33:350–358CrossRefPubMed Zhang J et al (2023) Association between migraine or severe headache and hypertension among US adults: a cross-sectional study. Nutr Metab Cardiovasc Dis NMCD 33:350–358CrossRefPubMed
32.
go back to reference Serrano D et al (2013) Effects of switching acute treatment on disability in migraine patients using triptans. Headache 53:1415–1429CrossRefPubMed Serrano D et al (2013) Effects of switching acute treatment on disability in migraine patients using triptans. Headache 53:1415–1429CrossRefPubMed
33.
go back to reference Levi M et al (2016) Patient adherence to olmesartan/amlodipine combinations: fixed versus extemporaneous combinations. J Manag Care Spec Pharm 22:255–262PubMed Levi M et al (2016) Patient adherence to olmesartan/amlodipine combinations: fixed versus extemporaneous combinations. J Manag Care Spec Pharm 22:255–262PubMed
Metadata
Title
Acute treatment of migraine: quantifying the unmet need through real-world data in Italy
Authors
Simona Sacco
Sonia Di Ciaccio
Roberto Di Virgilio
Valeria Pegoraro
Raffaele Ornello
Publication date
27-03-2024
Publisher
Springer International Publishing
Published in
Neurological Sciences
Print ISSN: 1590-1874
Electronic ISSN: 1590-3478
DOI
https://doi.org/10.1007/s10072-024-07493-w