Scientific Asia: A significant study discovered that certain new migraine medications are no more effective at treating attacks than paracetamol.
The thorough examination conducted by Oxford University researchers revealed that the most effective oral treatment was a less expensive class of drug called triptans.
Generally priced at almost one pound per pill, they outperform more recent medications, such as gepants, in terms of pain relief during attacks, which affect up to 190,000 individuals daily.
Experts stated that millions of sufferers should have greater access to triptans because they are “underused.”
However, the Migraine Trust advised physicians not to write off other drugs, stating that it is frequently “a painful trial and error” to identify what works for specific patients.
Researchers examined 137 randomized trials with nearly 90,000 participants who received a placebo or one of 17 medications.
Among these were triptans, which lessen the release of inflammatory chemicals and constrict blood arteries in the brain. These include eletriptan, rizatriptan, sumatriptan, and zolmitriptan.
A novel class of medications known as “gepants,” or ubrogepant, atogepant, and Rimegepant, were also studied. These medications attach to a protein that the brain releases at the beginning of a migraine episode.
These are estimated to cost approximately £12 per pill, which is up to twelve times the price of triptans.
For pain alleviation during an attack, all of them were contrasted with medications such as paracetamol and anti-inflammatory medicines.
According to the analysis, all medications reduced migraine pain more effectively than a placebo did within two hours, and most of them did so for up to 24 hours.
After two hours, rizatriptan, sumatriptan, and zolmitriptan were shown to be the most effective in relieving pain, after eletriptan.
The results reported in the BMJ showed that ibuprofen and eletriptan were the most effective for pain relief for up to 24 hours.
“We found that all the drugs licensed are better than placebo, but some are better than other active drugs for the acute treatment of migraine, which is something new,” said lead author Andrea Cipriani, a professor of psychiatry at the University of Oxford.
There are four types of these medications: rizatriptan, sumatriptan, eletriptan, and zolmitriptan. They are superior than the most recently released, priciest medications and also more effective than the other medications.
“The new drugs’ efficacy is comparable to that of paracetamol,” he continued. Not as good as the four triptans, but still better than the sugar pill.
“Considering the increased expense of these new treatments, this is important information to take into consideration.”
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It is believed that over 10 million persons in the UK suffer from migraines, with women being disproportionately affected. Symptoms of migraines include intense headaches, blurred vision, nausea, and vomiting.
Nice, the drug regulator, suggests zolmitriptan and sumatriptan for treating cluster headaches and eletriptan and rizatriptan for treating migraines.
Additionally, it approved rimegepant last year in cases when up to 145,000 persons had not responded to three prior treatments.
Triptans “can be highly effective for some,” according to Robert Music, chief executive of the Migraine Trust. However, many people are either intolerant to them or unable to take them because of medical issues including cardiovascular disease.
“Finding a migraine treatment that works can be extremely difficult and can take many years of painful trial and error,” he stated. “The consequences of this can be significant, including reduced mental health, impact on finances, and loss of employment.”
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“More accessibility to newer treatments when needed should be our goal, giving people more options and control over their care rather than deprioritizing them.”
According to Dr. Eloisa Rubio-Beltran, Research Associate at the Migraine Trust, additional studies are required to compare the efficacy of the medications in practical situations.
“The inclusion of individuals with actual migraine experiences in the study’s design should establish a standard in the field and be followed in subsequent research,” the speaker stated.
