Impact of semaglutide introduction on the use of triptans: an interrupted-time series

Emerging evidence suggests that glucagon-like peptide-1 receptor agonist (GLP-1RA) may be associated with reduced migraine burden. We aimed to evaluate whether semaglutide for weight management initiation is associated with changes in triptan consumption.

We conducted a nationwide interrupted time series analysis using Danish health registers. All adults initiating semaglutide between December 2022 and December 2024 were included. The first dispensing date served as the index date, establishing a 24-month baseline and a 12-month follow-up period. The primary outcome was monthly triptan consumption (defined daily doses (DDD)/10,000 individuals). Analyses were conducted for new and prevalent triptan users, and stratified by sex, age group, and prior use of prophylactic antimigraine medication.

During the study period, 189,392 individuals initiated semaglutide (68% females, median age 50 years). Before initiation, triptan use increased over time; after initiation, this trend reversed, showing a decline of -13 DDD/month/10,000 (95% CI: -25 to -1.3), corresponding to a 7% relative reduction at 12 months (RR 0.93; 0.88-0.97). This decrease primarily reflected a reduction in DDD consumption among prevalent users (RR 0.86; 0.82-0.90) rather than a change in monthly rates of new users. A sex-specific effect was observed, with female users demonstrating an 8% reduction (RR 0.92; 0.88-0.97) and males showing no statistically significant change. The largest reductions occurred in individuals aged 18-35 years (RR 0.86; 0.78-0.94) and previous users of prophylactic antimigraine medications (RR 0.88; 0.82-0.94).

Weight-loss semaglutide initiation was associated with a modest, gradual reduction in triptan use, particularly among females and individuals with history of migraine.