New, more expensive migraine drugs are no more effective against headaches than traditional painkillers and even perform worse than an older range of treatments called triptans.
This is clear from a large-scale global analysis, reported AFP.
Migraine is a severe, often debilitating headache that affects at least one in seven adults worldwide, according to the World Health Organization. Migraines are up to three times more common in women than in men.
For decades, cheap and widely available pain relievers like aspirin and ibuprofen have been prescribed for migraines, as have the more powerful triptans, which change the way blood circulates in the brain.
But in recent years, a new generation of migraine medications called gepants has emerged. These include rimegepant, sold by US pharmaceutical giant Pfizer under the brand name Vydura, and ubrogepant, sold as Ubrelvy by Abbvie.
Migraine drugs can make big bucks for drug companies. Pfizer acquired Biohaven, which developed rimegepant, for more than $10 billion in 2022.
These new drugs are usually tested against a placebo.
A new meta-analysis published in the journal BMJ brought together 137 controlled trials looking at how 17 different treatments affected a total of 90,000 people.
The newer and more expensive drugs rimegepant and ubrogepant - as well as another called lasmiditan, which can have side effects such as drowsiness - were almost as effective as paracetamol and anti-inflammatory painkillers, the study said.
Meanwhile, triptans - such as eletriptan, rizatriptan, sumatriptan and zolmitriptan - perform best but are underutilized by patients.
The researchers recommend that doctors first prescribe triptans -- and for some patients who can't take them because of heart problems, they recommend traditional pain relievers like aspirin and ibuprofen.
Newer hepant drugs should only be considered as a third option.
Study co-author Andrea Cipriani from the University of Oxford stressed the importance of properly treating the "huge problem" called migraine.
"It is the leading cause of disability in young women and is also associated with high personal and societal health care costs," he told a news conference. | BGNES
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