Abstract
BackgroundAlthough migraine is a disabling neurological condition that causes important disability, it remains an area of underdiagnosis and undertreatment worldwide. The aim of this study was to depict the burden of the unmet medical needs in migraine treated with triptans in a large Italian population.MethodsA 2-year longitudinal analysis of migraineurs with unmet medical needs on treatment with triptans was performed. The studied cohort consisted of subjects with ≥4 triptan dose units per month, selected from the general population These patients were stratified into: possible Low-Frequency Episodic Migraine (pLF-EM: 4–9 triptan dose units per month), possible High-Frequency Episodic Migraine (pHF-EM: 10–14 triptan dose units per month) and possible Chronic Migraine (pCM:> 14 triptan dose units per month). The first follow-up year was analysed to describe the use of preventive therapies, the second year to describe the ≥50% reduction in triptan use.ResultsOf 10,270,683 adults, 8.0 per 1000 were triptan users and, of these, 38.2% were migraineurs with unmet medical needs, corresponding to 3.1 per 1000 adults. By stratifying for the number of triptan dose units per month, 72.3% were affected by pLF-EM, 17.4% by pHF-EM, and 10.3% by pCM. In this cohort, 19.1% of individuals used oral preventive drugs and 0.1% botulinum toxin. Triptan use reduction was found in 22.3% individuals of the cohort, decreasing with the intensification of need levels (25.8% pLF-EM, 13.6% pHF-EM, 12.0% pCM).ConclusionsThis real-life analysis underlined that the unmet medical needs concern a large part of patients treated with triptans and there is an undertreatment with preventive therapies whose benefit is insufficient, which may be due to the lack of effective preventive strategies, probably still reserved to severe patients. This study allows forecasting the actual impact of newest therapeutic strategies aimed to fill this gap.
Highlights
The World Health Organization has declared migraine the third most common disease and the second cause of disability [1]
In Italy, there are scarce epidemiological data on chronic migraine (CM): a questionnaire-based study involving 16,577 subjects reported that the prevalence of people suffering from headache attacks for more than 15 days per month was 3.4%, despite many patients being misdiagnosed by general practitioners [9]
Prevalence and socio-demographic characteristics of unmet medical needs (UMN) migraineurs Starting from a population of 12,217,384 subjects resident in 6 Italian Regions in 2013, 10,270,683 were adults and, out of these, 85,048 (0.83% of adults) received at least one prescription of triptan during 2013
Summary
The World Health Organization has declared migraine the third most common disease and the second cause of disability [1] It affects roughly 12–14% of the adults in occidental countries and it is most common in the age class 35–45 years old, with a prevalence three times higher in women than in men [2, 3]. In Europe, the estimate of migraine prevalence comes mainly from studies based on personal interviews or questionnaires: a mean prevalence of 14.7% has been found, with few Italian studies included in this estimate [4] This elevated prevalence is associated with a huge economic impact, both as direct and indirect costs: a study estimated that for migraine the mean per-person annual costs were €1222 with a total annual cost of €111 billion for 27 European Countries [5]. The aim of this study was to depict the burden of the unmet medical needs in migraine treated with triptans in a large Italian population
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have