Utilization patterns, cardiovascular risk, and concomitant serotoninergic medications among triptan users between 2008 and 2018: A gender analysis in one Italian region, Tuscany
- 27 January 2023
- journal article
- research article
- Published by Wiley in Headache: The Journal of Head and Face Pain
- Vol. 63 (2), 222-232
- https://doi.org/10.1111/head.14463
Abstract
ObjectiveTo describe the pattern of triptan use by gender in Tuscany, Italy, focusing on special user populations in which evidence on triptan safety is still not conclusive. BackgroundGrowing evidence supports the role of gender differences in migraine pathophysiology and treatment. However, gender impact on triptan real-word utilization has been poorly investigated. MethodsA retrospective, descriptive, cohort study was performed using the population-based Administrative Healthcare Database of Tuscany region (Italy). Subjects registered in the database on the January 1 of each year between 2008 and 2018 were identified. New users (NU) of triptans (ATC:N02CC*) were patients with one or more triptan dispensation during the year of interest and none in the past. Age, cardiovascular comorbidities representing an absolute or a possible contraindication to triptan utilization, concomitant serotonergic medications, and pattern of triptan use during 1-year follow-up were described by gender. ResultsA total of 86,109 patients who received one or more triptan dispensing were identified. Of 64,672 NU (men = 17,039; women = 47,633), 10.2% (6823/64,672) were aged >65 years, who were mostly women (n = 4613). Among NU, men and women with absolute cardiovascular contraindications were 4.3% (740/17,039) and 2.1% (1022/47,633), respectively, while those concomitantly taking serotonergic medications were 17.2% (267/1549) and 21.9% (949/4330), respectively (949/4330). Regular users (two or more dispensing with >= 3 months between first and last observed dispensing) accounted for 26.4% of women (12,597/47,633) and 19.11% of men (3250/17,039); frequent users (>= 15 dosage units/month during >= 3 consecutive months) were overall 0.1% (94/64,672) and 62.0% (58/94) of them concomitantly received serotonergic medications. ConclusionConsidering gender differences in triptan use highlighted here, large scale observational studies are warranted to better define what populations are safe to use triptans and whether it is appropriate to tighten or relax certain recommendations on triptan use. In the meantime, any suspected adverse drug reaction observed in the special user populations highlighted in this study should be promptly reported.Keywords
This publication has 37 references indexed in Scilit:
- Italian guidelines for primary headaches: 2012 revised versionThe Journal of Headache and Pain, 2012
- Subcutaneous delivery of sumatriptan in the treatment of migraine and primary headachePatient Preference and Adherence, 2012
- The FDA Alert on Serotonin Syndrome With Use of Triptans Combined With Selective Serotonin Reuptake Inhibitors or Selective Serotonin‐Norepinephrine Reuptake Inhibitors: American Headache Society Position PaperHeadache: The Journal of Head and Face Pain, 2010
- Triptans: Low utilization and high turnover in the general populationCephalalgia, 2009
- Triptans in the Italian population: a drug utilization study and a literature reviewThe Journal of Headache and Pain, 2008
- Patterns of Triptans Use: A Study Based on the Records of a Community Pharmaceutical DepartmentCephalalgia, 2007
- Triptans—Why Once?Headache: The Journal of Head and Face Pain, 2006
- Intensive community pharmacy intervention had little impact on triptan consumption: A randomized controlled trialScandinavian Journal of Primary Health Care, 2006
- Consensus Statement: Cardiovascular Safety Profile of Triptans (5‐HT1B/1D Agonists) in the Acute Treatment of MigraineHeadache: The Journal of Head and Face Pain, 2004
- Tolerability of the TriptansDrug Safety, 2003