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[The Vigimig study of naratriptan use in general practice]
Michel Lanteri-Minet1, Fatima Nachit-Ouinekh, Pierre-Louis Druais
1Service de neurologie, Hôpital Pasteur, Nice.
Presse Medicale (Paris, France : 1983)
|August 1, 2007
Summary
Naratriptan is prescribed for severe migraines in France, often after NSAID failure, aligning with guidelines. However, delayed treatment by one-third of patients may reduce naratriptan efficacy for acute headaches.
Area of Science:
- Neurology
- Pharmacoepidemiology
Background:
- Migraine is a common neurological disorder impacting quality of life.
- Triptans, including naratriptan, are effective acute headache treatments.
- France has established guidelines for triptan use in migraine management.
Purpose of the Study:
- To evaluate the prescription and utilization patterns of naratriptan in French community medicine.
- To assess how naratriptan fits within the broader landscape of migraine pharmacotherapy.
Main Methods:
- A pharmacoepidemiological study involving 2530 general practitioners and 3863 migraine patients in France.
- Data collection via physician and patient questionnaires (including HIT-6 and QVM) and patient diaries.
- Random selection of general practitioners to ensure representative sampling.
Main Results:
- Naratriptan was prescribed to 54.3% of patients, with 82.3% being women.
- Patients receiving triptans experienced greater migraine impact and poorer quality of life compared to non-triptan users (p<0.0001).
- Naratriptan was frequently used as a second-line treatment after NSAID failure (44.2%), with 55.3% receiving a single dose per headache. Initial treatment was timely in 70.5% of cases.
Conclusions:
- Naratriptan is predominantly prescribed for severe migraines, consistent with French guidelines.
- Physicians often recommend naratriptan as a second-line therapy post-NSAID failure.
- A significant proportion of patients (one-third) delay treatment initiation, potentially compromising naratriptan's effectiveness and increasing recurrence risk.
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