Abstract Details

Title Switching and Discontinuation Patterns Among Triptan Users: A Systematic Literature Review

Topic Headache

Presentation(s) P3 - Poster Session 3 (12:00 PM-1:00 PM)

Poster/Presentation
Number 7-013

Objective The objective was to characterize real-world discontinuation of triptans, to better understand current unmet need for safe and effective acute treatments for migraine.

Background Migraine is a highly prevalent neurological disorder affecting 15% of Americans. Triptans, a class of medication for moderate-to-severe migraine attacks, are associated with adverse events, variable response rates and cardiovascular contraindications.

Design/Methods A systematic literature review, conducted using MEDLINE and EMBASE under the PICOS criteria, identified articles that characterize burden associated with current treatment options for migraine. Estimates of 2-year retention (refilling one or more prescriptions of index triptan within 90 days before the end of the 2-year follow-up period), discontinuation (discontinuing all prescription migraine therapies), within-class switching (WCS) (to a different triptan), and between class-switching (BCS) (to a different class of migraine therapy) were summarized.

Results From 5,770 records identified, 743 full-text articles were screened; seven studies reported on treatment patterns among triptan users. Included studies comprised four database studies, single- and multi-center retrospective studies, and a survey questionnaire. Data were identified from the United States, Asia, and Europe. Across studies, migraine definition and demographic distributions were similar. 2-year retention rates ranged from 4.0% to 13.0%, discontinuation from migraine therapies ranged from 24.8% to 54.9%, WCS to another triptan ranged from 0.01% to 7.4%, and BCS to other therapies ranged from 2.3% to 67.1%. WCS was associated with increased headache-related disability. Commonly-reported reasons for WCS were insufficient treatment response or AEs, reasons for BCS included contraindications for triptan use, and reasons for discontinuation from therapy included attack-freedom.

Conclusions

This evidence demonstrates a range of discontinuation and switching rates among triptan users globally. Variation included differences in follow-up, study design, and availability of triptans by country. Overall, relatively high rates of triptan switching and discontinuation demonstrate a high unmet need.

Authors/Disclosures
Alison Deighton PRESENTER	Alison Deighton has nothing to disclose.
Karissa Johnston	Karissa Johnston has nothing to disclose.
	No disclosure on file
	No disclosure on file
Gilbert J. L'Italien	Gilbert J. L'Italien has received personal compensation for serving as an employee of Biohaven Pharmaceuticals. Gilbert J. L'Italien has stock in biohaven pharmaceuticals.
Richard B. Lipton, MD, FAAN (Albert Einstein College of Medicine)	Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Allergan/Abbvie. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Amgen. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Biohaven. Dr. Lipton has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for Eli Lilly. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Lundbeck. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for GlaxoSmithKline. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Teva. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Vedanta. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Grifols. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Pfizer. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Axon. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Satsuma. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Cool Tech. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BDSI. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Linpharma. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Axsome. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Clexio. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Shiratronics. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Allergan/Abbvie. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biohaven. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Eli Lilly. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Lundbeck. Dr. Lipton has or had stock in Biohaven.Dr. Lipton has or had stock in Manistee.Dr. Lipton has or had stock in Axon.Dr. Lipton has or had stock in CoolTech. The institution of Dr. Lipton has received research support from Teva. The institution of Dr. Lipton has received research support from Amgen. The institution of Dr. Lipton has received research support from Allergan/Abbvie. The institution of Dr. Lipton has received research support from Gammacore. The institution of Dr. Lipton has received research support from Axsome. The institution of Dr. Lipton has received research support from Charleston Labs. The institution of Dr. Lipton has received research support from Eli Lilly. The institution of Dr. Lipton has received research support from Satsuma. The institution of Dr. Lipton has received research support from NIH . The institution of Dr. Lipton has received research support from Veterans Administration. Dr. Lipton has received publishing royalties from a publication relating to health care.

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