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Older migraine drugs more effective than some newer options, study finds

Sep 24, 2024

• Migraine attacks can be painful to experience, and many medications are available to help with treatment.

• One systematic review and network meta-analysis found that certain triptans may be more effective treatment options than more recently available migraine medications.

• Findings from this review may be helpful in guiding migraine treatment recommendations.

Finding the right medication to help with migraine attacks can make all the difference in symptom relief. Experts are interested in finding the best medication choices and comparing them.

A systematic review and network meta-analysis published in The BMJO compared the options for oral monotherapy treatment of migraine attacks, looking at data from 137 randomized controlled trials and almost 90,000 individuals.

Overall, eletriptan was the most effective at eliminating pain after 2 hours, and one of the most helpful in achieving sustained freedom from pain.

The evidence also suggested that certain triptan medications were more effective than more recent migraine drugs like lasmiditan and ubrogepant.

Most triptans better for pain relief than newer migraine drugs

Migraine attacks involve, among other symptoms, painful headaches that can last for days. Medications can be a common option for symptom relief. One type of medication used to treat acute migraine is uptans , which ultimately helps constrict blood vessels and block pain signals to improve migraine symptoms.

In this review, researchers wanted to compare oral monotherapy options for migraines. They looked for studies from several sources, including the Cochrane Central Register of Controlled Trials and the World Health Organization International Clinical Trials Registry Platform. They included double-blind, randomized controlled trials that compared by-mouth medications to a placebo or other treatment.

The trials included individuals who were at least 18 years old and had a diagnosis of migraine. Researchers focused on freedom from pain 2 hours after taking medication and 2—24 hours after taking medication. They included 137 randomized controlled trials and looked at the effects of 17 medications. Among participants, 62,682 received drug-based treatments, while 26,763 received a placebo.

All medications were superior to the placebo. When comparing the drug interventions, researchers found that at the 2-hour mark, eletriptan was more effective than almost “all of the other active interventions” in achieving freedom from pain and in terms of participants using rescue drugs.

At the 2-hour mark, the next most effective medications were rizatriptan, sumatriptan, and zolmitriptan. When looking at sustained freedom from pain, researchers found that eletriptan and ibuprofen were the most effective.

Researchers concluded that eletriptan, rizatriptan, sumatriptan, and zolmitriptan were more effective than lasmiditan, rimegepant, and ubrogepant, which are more recently developed migraine treatment medications.

Study author Andrea Cipriani, MD, PhD, a professor of psychiatry at the University of Oxford in the United Kingdom, noted the following highlights of the research to Medical News Today.

Source: Medical News Today

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