Pattern of triptan use and cardiovascular coprescription: a pharmacoepidemiological study in Italy

We evaluated the incidence, prevalence, and patterns of triptan use with a special focus on patients who also received cardiovascular drugs, considered as a deviation from appropriate triptan use.

We collected data on prescriptions reimbursed in between 2006 and 2008 in an Italian region. Patients receiving at least one prescription of triptans from January to December 2007 were divided in two populations: new users (without triptan prescriptions in 2006), and already in treatment. All patients were followed for 12 months in terms of both triptan use and cardiovascular coprescriptions.

One-year prevalence of triptan use was 0.8%, whereas the incidence was 0.4%. New users accounted for 47.5% of total users (34,915). The percentages of very frequent users (>120 and >180 dosage unit per year) were about double among those already in treatment (26.6% and 15.3%, respectively) and new users (1% and 0.3%; p < 0.01). Patients starting with the lowest dose of tablet formulation were more likely to interrupt therapy after their first prescription (p < 0.01). Many users aged >65 received concomitant cardiovascular therapies: 36.6% among new users and 64.3% for already in treatment (p < 0.01). In both groups, about 5% of elderly patients received coprescriptions, suggesting a high deviation from appropriate triptan use.

A higher percentage of very frequent users was detected in patients already in treatment compared with new users. Moreover, the percentage of nonnegligible triptan recipients were in age groups for which the drug is not recommended by the product label (≤18 years and >65) and who had cardiovascular coprescriptions suggestive of vasoconstrictive risk.