Acute treatment patterns in patients with migraine newly initiating a triptan

Richard B. Lipton, Steven C. Marcus, Anand R. Shewale, David W. Dodick, Hema N. Viswanathan, Jalpa A. Doshi

Research output: Contribution to journalArticle

Abstract

Background: Triptans are the most commonly used acute treatment for migraine. This study evaluated real-world treatment patterns following an initial triptan prescription to understand refill rates and use of non-triptan medications for the acute treatment of migraine. Methods: Commercially-insured adult patients over 18 years of age with a triptan prescription between 1/1/2013 to 31/12/2013 were identified from the Optum Clinformatics™ Data Mart database, with date of the first triptan fill designated as index date. Inclusion was limited to those with no fills for a triptan in the 12 months prior to index date (i.e. new users or initiators of triptans) and continuous enrollment in the 12 months pre- and 24 months post-index date. Fills for index triptan, non-index triptan, and other acute treatments for migraine were assessed for up to 24 months post-index. Results: Among 10,509 patients, 50.8% did not refill the initial triptan within 12 months and 43.6% did not refill within 24 months. In the 12 months post-index, 90.5% of patients used only one type of triptan, 8.4% used two different triptans, and 1.0% used three or more triptans. Among patients with and without a triptan refill, use of opioids (39% vs. 42%), non-steroidal anti-inflammatory drugs (22% vs. 22%), and butalbital-containing products (9% vs. 10%) were similar. Conclusion: More than half of those who newly initiated a triptan did not refill their initial prescription, and less than 1 in 10 used two or more triptans within 12 months. High rates of non-triptan acute medication use were found over 12 and 24 months of follow-up, most commonly opioids.

Original languageEnglish (US)
Pages (from-to)437-447
Number of pages11
JournalCephalalgia
Volume40
Issue number5
DOIs
StatePublished - Apr 1 2020

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Keywords

  • Triptan persistency
  • claims data
  • migraine medication
  • refill patterns

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Lipton, R. B., Marcus, S. C., Shewale, A. R., Dodick, D. W., Viswanathan, H. N., & Doshi, J. A. (2020). Acute treatment patterns in patients with migraine newly initiating a triptan. Cephalalgia, 40(5), 437-447. https://doi.org/10.1177/0333102420905307