Triptan non-response in specialized headache care: cross-sectional data from the DMKG Headache Registry

Area of Science:

• Neurology
• Pharmacology
• Headache Medicine

Background:

• Triptans are a common migraine treatment, but efficacy and tolerability vary.
• The European Headache Federation (EHF) defines 'triptan resistance' as failure of two or more triptans.
• Data on the frequency of triptan resistance is limited.

Purpose of the Study:

• To determine the frequency of triptan resistance in a German migraine patient cohort.
• To investigate the association between triptan resistance and migraine severity.
• To inform acute treatment strategies for migraine.

Main Methods:

• Utilized patient self-report data from the German Migraine and Headache Society (DMKG) Headache Registry.
• Assessed triptan response, efficacy, and tolerability failure in 2284 adult migraine patients.
• Analyzed data based on the number of failed triptan treatments.

Main Results:

• 13.1% of patients met the EHF definition of triptan resistance (failed ≥2 triptans).
• Triptan non-responders exhibited significantly higher migraine frequency, intensity, and disability compared to responders.
• Nasal zolmitriptan, oral eletriptan, and subcutaneous sumatriptan showed the highest responder rates.

Conclusions:

• In specialized German headache care, 13.1% of patients demonstrated triptan resistance.
• Triptan failure is linked to increased migraine severity and disability.
• Optimizing acute migraine treatment may involve switching triptans or medication classes.