Sex Differences in Response to Triptans: A Systematic Review and Meta-analysis

Area of Science:

• Pharmacology
• Neurology
• Clinical Trials

Background:

• Migraine treatment efficacy and safety can vary between sexes.
• Triptans are a common class of acute migraine medications.
• Understanding sex-based differences in triptan response is crucial for personalized medicine.

Purpose of the Study:

• To investigate the impact of sex on clinical outcomes following triptan treatment for migraine.
• To determine if pharmacokinetic differences between men and women influence triptan response.

Main Methods:

• Systematic review and meta-analysis of published clinical trials.
• Searched major databases (PubMed, MEDLINE, Cochrane, Embase, Web of Science) up to December 2019.
• Calculated pooled risk ratios for clinical outcomes and ratios of means for pharmacokinetic parameters.

Main Results:

• Analyzed 19 studies with 2,280 men and 13,899 women.
• No significant sex differences in 2-hour headache or pain-free response rates.
• Men showed lower headache recurrence (RR 0.64) and adverse event risk (RR 0.82).
• Men had lower triptan exposure (AUC RoM 0.69, Cmax RoM 0.72) compared to women.

Conclusions:

• Limited data exist on sex differences in triptan response.
• Women exhibit higher triptan exposure but not improved response rates.
• Sex differences in adverse events may relate to drug exposure; higher recurrence in women may be linked to hormonal factors and longer attack duration.