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A recent analysis published in The BMJ on September 18, 2024, has shed light on the superiority of traditional migraine treatments known as triptans over newer, more expensive medications. Researchers argue that triptans, particularly eletriptan and rizatriptan, could significantly improve migraine management worldwide if their usage were standardized and promoted more aggressively.
Key Findings on Triptans
The study indicates that four triptans—eletriptan, rizatriptan, sumatriptan, and zolmitriptan—were notably more effective in alleviating migraine pain compared to recently introduced drugs such as lasmiditan, rimegepant, and ubrogepant. The newer medications performed similarly to common pain relievers like paracetamol and nonsteroidal anti-inflammatory drugs (NSAIDs). This finding raises questions about the need for more expensive options when effective treatments are already available.
Triptans work by constricting blood vessels in the brain and inhibiting the release of pain-causing chemicals, which makes them particularly effective for acute migraine episodes.
Global Impact of Migraine
Migraine is a pervasive issue, affecting over one billion people globally and ranking as the leading cause of disability among women and girls aged 15 to 49. Despite the availability of various medications, there has been no consensus on the most effective options. This study aimed to clarify that by analyzing 137 randomized controlled trials involving nearly 90,000 participants.
Study Methodology
The researchers conducted a thorough review of trials published up to June 24, 2023, to assess the efficacy of 17 different oral drugs for acute migraine treatment. They found that all drugs were more effective than placebo at relieving pain within two hours, with most providing sustained relief for up to 24 hours. Eletriptan emerged as the most effective for immediate pain relief, followed closely by rizatriptan, sumatriptan, and zolmitriptan.
Recommendations for Global Accessibility
The study’s authors advocate for the inclusion of these high-performing triptans in the WHO Model List of Essential Medicines to enhance global access and standardize migraine care. They also recognize that some patients may be unable to use triptans due to preexisting health conditions or side effects.
Despite the limitations of the available data, the researchers emphasize that these findings represent the best current evidence for guiding the choice of acute migraine treatments. They encourage shared decision-making between healthcare providers and patients to ensure optimal care.
In conclusion, as the quest for effective migraine relief continues, it appears that the best solution may already be sitting in your medicine cabinet. By promoting the use of triptans, healthcare systems worldwide could significantly improve the quality of care for millions suffering from migraines.
Reference: Karlsson, W. K., Ostinelli, E. G., Zhuang, Z. A., et al. (2024). Comparative effects of drug interventions for the acute management of migraine episodes in adults: systematic review and network meta-analysis. BMJ. DOI: 10.1136/bmj-2024-080107.
