Priorities for triptan treatment attributes and the implications for selecting an oral triptan for acute migraine: a study of US primary care physicians (the TRIPSTAR project)

Cutrer, F. Michael; Goadsby, Peter J.; Ferrari, Michel D.; Lipton, Richard B.; Dodick, David W.; McCrory, Douglas C; Williams, Paul

doi:10.1016/j.clinthera.2004.09.011

Cited by 18 publications

(16 citation statements)

References 22 publications

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“…Surveys of patient attitudes about acute migraine medications indicate that the most important attributes are rapid onset of pain relief, complete pain relief, few or no side effects, and no headache recurrence . Previous research into unmet needs among individuals with migraine has shown that nearly 40% are dissatisfied .…”

Section: Introductionmentioning

confidence: 99%

Unmet Acute Treatment Needs From the 2017 Migraine in America Symptoms and Treatment Study

Lipton

Munjal²,

Buse

et al. 2019

Headache

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Objectives To characterize unmet treatment needs in a sample of Migraine in America Symptoms and Treatment (MAST) Study participants using oral, acute prescription migraine medications. Background The MAST Study is a 2017 study of US adults with migraine that profiles current treatment patterns and identifies and quantifies unmet treatment needs. Methods Cross‐sectional data from an online survey of US adults meeting ICHD‐3 beta criteria for migraine. For inclusion in this paper, respondents self‐reported a history of 3 or more monthly headache days (MHDs) in the past 3 months and at least 1 MHD in the past 30 days, and current use of orally administered acute prescription medication for headache. Three domains of unmet need were identified: inadequate treatment response (ie, inadequate 2‐hour pain freedom, recurrence within 24 hours of initial relief), demanding attack characteristics (rapid onset of attack, headache associated with sleep), and unique patient characteristics (opioid or barbiturate overuse, cardiovascular comorbidity). Sociodemographics, oral medication use, and coexisting conditions and symptoms (ie, level of treatment optimization, psychological symptoms, attack‐related cutaneous allodynia, and migraine symptom severity) were assessed for each domain and by the number of unmet need domains. Results Overall, 15,133 respondents met inclusion criteria, 26.0% (3930/15,133) reported current use of oral acute prescription medication to treat headache. Eligible participants had a mean age of 45.0 years, 73.6% [2892/3930] were women and 81.1% [3186/3930]) were White. A total of 95.8% (3765/3930) of respondents had at least 1 unmet acute treatment need; 89.5% (3516/3930) reported demanding attack characteristics, 74.1% (2912/3930) reported inadequate treatment response, and 16.1% (634/3930) presented with unique patient characteristics. Common areas of unmet need were rapid headache onset (65.3% [2567/3930]), moderate to severe disability (55.6% [2187/3930]), inadequate 2‐hours pain freedom (49.0% [1892/3930]), and headache recurrence within 24 hours (38.0% [1493/3930]). An increasing number of unmet treatment need domains was associated with worsening psychological symptoms, attack‐related cutaneous allodynia and migraine symptom severity. Conclusion Nearly all MAST Study respondents using acute oral prescription medications for migraine reported at least 1 unmet treatment need. As unmet needs increased, so did coexisting conditions and symptom severity.

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Section: Introductionmentioning

confidence: 99%

Unmet Acute Treatment Needs From the 2017 Migraine in America Symptoms and Treatment Study

Lipton

Munjal²,

Buse

et al. 2019

Headache

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“…In this project, the same 3 triptans, almotriptan, eletriptan and rizatriptan, emerged as the preferred subset, irrespective of whether the attribute importance weights were obtained from neurologists [9], primary care physicians [10] or migraineurs [11,12]. Similarly, almotriptan, eletriptan and rizatriptan were more similar (than sumatriptan, naratriptan or zolmitriptan) to a hypothetical "ideal triptan", when compared using >10 000 sets of computer-generated importance weights which reflected the entire range of values for relative attribute importance [13].…”

Section: Discussionmentioning

confidence: 99%

Selecting the preferred triptans

McCrory

Williams

2004

J Headache Pain

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The objective was to identify a subset of preferred triptans from among available agents. A criterion of dominance was applied to statistically significant differences which emerged from a recent meta-analysis of placebo-controlled trials of the oral triptans in the treatment of acute migraine. Three alternatives—almotriptan 12.5 mg, eletriptan 80 mg and rizatriptan 10 mg—emerged as nondominated. These were not only superior on an individual basis, but, taken as a group, provided statistically significant superiority over the reference product (sumatriptan 100 mg) on all 5 treatment attributes studied. However, one of these, eletriptan 80 mg, is not approved for use as first line treatment, so the subset of preferred triptans for the treatment of acute migraine therefore comprises almotriptan 12.5 mg and rizatriptan 10 mg. Thus, almotriptan 12.5 mg and rizatriptan 10 mg are the preferred agents for the treatment of acute migraine.

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“…Research has shown that although a variety of attributes are desirable, rapid onset of complete pain relief is considered particularly important both by clinicians and patients (Lipton et al 2002). In a survey of US primary care physicians, rapid achievement of pain-free and sustained pain-free status were considered the most important efficacy attributes of triptan treatment (Cutrer et al 2004). …”

Section: Patient Support and Disease Management Programsmentioning

confidence: 99%

Rizatriptan in the treatment of migraine

Láinez

2006

Neuropsychiatric Disease and Treatment

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Migraine is a common, disabling disorder associated with considerable personal and societal burden. Current guidelines recommend triptans for the acute treatment of migraine unlikely to respond to less effective therapies. Rizatriptan is a second-generation triptan available in tablet or orally disintegrating tablet (wafer) formulations that offers several advantages over other members of its class. Rizatriptan is rapidly absorbed from the gastrointestinal tract and achieves maximum plasma concentrations more quickly than other triptans, providing rapid pain relief. Clinical trials have shown that rizatriptan is at least as effective or superior to other oral migraine-specifi c agents in the acute treatment of migraine, and has more consistent long-term effi cacy across multiple migraine attacks. Rizatriptan has a favorable tolerability profi le, and patients have reported greater satisfaction and a preference for rizatriptan over other migraine-specifi c agents. Improvements in quality of life reported with rizatriptan are consistent with its favorable effi cacy and tolerability profi les. Notably, multi-attribute decision models that combine clinical data with patient-and physician-reported treatment preferences have identifi ed rizatriptan as one of three triptans closest to a hypothetical "ideal". The effi cacy and tolerability of rizatriptan for the acute treatment of migraine have thus been well established.

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Priorities for triptan treatment attributes and the implications for selecting an oral triptan for acute migraine: a study of US primary care physicians (the TRIPSTAR project)

Cited by 18 publications

References 22 publications

Unmet Acute Treatment Needs From the 2017 Migraine in America Symptoms and Treatment Study

Unmet Acute Treatment Needs From the 2017 Migraine in America Symptoms and Treatment Study

Selecting the preferred triptans

Rizatriptan in the treatment of migraine

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