New migraine options needed

Almost 5 million Americans with episodic migraine (EM) should not be prescribed a triptan, the only class of acute medications FDA approved and developed for migraine, because of the presence of cardiovascular contraindications, according to results from the American Migraine Prevalence and Prevention (AMPP) study.

The results of the study were presented in June at the 2013 International Headache Congress in Boston.

 “Triptans are widely prescribed and effective; however their use is contraindicated with persons with cardiovascular [CV] event histories and conditions,” according to Dawn Buse, PhD, associate professor of neurology, Albert Einstein College of Medicine, Montefiore Headache Center, New York City. “This leaves a substantial number of individuals without safe and effective treatment for migraine. Awareness of this unmet need and the resulting need for safe and effective therapies for this large group of patients is vital to the effective care of persons with migraine.”

The study analyzed 6,723 patients with EM.

CV Events and Procedures

Aged <40

Aged 40-59

Aged ≥60

Myocardial Infarction

6 (0.4%)

112 (3.4%)

104 (8%)

TIA

17 (1.2%)

135 (3.9%)

101 (7.2%)

Stroke

11 (0.8%)

72 (2.1%)

76 (5.4%)

Claudication

85 (6.2%)

294 (8.6%)

182 (13.1%)

Angina

58 (4.2%)

271 (7.9%)

192 (13.7%)

Coronary Bypass Surgery

11 (0.8%)

41 (1.1%)

49 (3.2%)

Coronary Angioplasty/Stenting

15 (1.0%)

114 (3.1%)

100 (6.5%)

Carotid Artery Surgery/Stenting

10 (0.7%)

28 (0.8%)

22 (1.4%)

Peripheral Artery Bypass Surgery

10 (0.7%)

32 (0.9%)

16 (1%)

Respondents with ≥1 Event/Procedure

151 (11.1%)

623 (18.7%)

460 (33.6%)