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Study Compares Effectiveness of Migraine Preventive Drugs

Simvastatin, CGRPabs, amitriptyline more likely to achieve a clinically significant reduction in triptan use

By Elana Gotkine HealthDay Reporter

FRIDAY, Dec. 22, 2023 (HealthDay News) — For patients with migraine, simvastatin, calcitonin gene-related peptide pathway antibodies (CGRPabs), and amitriptyline have a favorable effect compared with beta blockers, according to a study published in the January issue of the European Journal of Neurology.

Marte H. Bjørk, M.D., Ph.D., from the University of Bergen in Norway, and colleagues estimated retention, defined as the number of uninterrupted treatment days, and effectiveness, defined as the reduction in filled triptan prescriptions during four 90-day periods after the first preventive prescription compared with a 90-day baseline period in 104,072 patients with migraine. Retention and efficacy were compared for different drugs against beta blockers.

The researchers found that botulinum toxin and CGRPabs were the least likely to be discontinued compared with beta blockers (hazard ratios, 0.43 and 0.63, respectively), while the most likely to be discontinued were clonidine and topiramate (hazard ratios, 2.95 and 1.34, respectively). The likelihood of achieving a clinically significant reduction in triptan use during the first 90 days of treatment was increased for those on simvastatin, CGRPabs, and amitriptyline, with propensity score-adjusted odds ratios of 1.28, 1.23 and 1.13, respectively.

“Our analysis shows that some established and cheaper medicines can have a similar treatment effect as the more expensive ones,” Bjørk said in a statement. “This may be of great significance both for the patient group and Norwegian health care.”

Several authors disclosed ties to pharmaceutical companies, including Novartis, which funded the study.

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