2024-09-18 22:30:00
Logic says that new drugs should be better than traditional ones but, according to research published in ‘The BMJ‘, it’s not always that way. According to the results of a meta-analysis conducted by an international group on 137 clinical trials involving nearly 90,000 peopleThe effectiveness of migraine drugs from the triptan family is greater than that of new drugs recently marketed such as gepantes or lasmiditan, and the effectiveness of the latter is comparable to that of paracetamol and of many antibiotics. In addition, they are more cheap.
In particular, the most effective triptans are eletriptan, rizatriptan, sumatriptan and zolmitriptan.
Triptans work by constricting blood vessels in the brain and preventing the release of chemicals that cause pain and inflammation.
The researchers maintain that triptans are underused and say that access to the most effective triptans should be promoted worldwide and international guidelines updated accordingly.
Migraine affects more than a billion people worldwide and is the leading cause of disability in girls and women between the ages of 15 and 49 years. There are many drugs, but there is no clear consensus on which one works best.
To address this issue, researchers searched scientific databases to identify randomized controlled trials published by May 24, 2023 that compared oral medications licensed for treatment severe migraine in adults.
Migraine affects more than a billion people worldwide and is the leading cause of disability in girls and women between the ages of 15 and 49 years.
We included 137 randomized controlled trials with 89,445 participants randomized to one of 17 individual drugs or placebo.
When comparing the drugs with each other, the eletriptan is the most effective drug in reducing pain in two hours, followed by rizatriptanhim Sumatriptan and the zolmitriptan. For delayed pain relief for 24 hours, the most effective drugs are eletriptan and ibuprofen.
The researchers note that the best triptans should be considered the treatment of choice for migraine episodes and should include WHO List of Essential Medicines to promote universal access and uniform standards of care.
However, experts are advised by Science Media Center appropriate these data. Now, Patricia Pozo Rosich, of the Neurology Service of the Hospital Vall d’Hebron in Barcelona. And although they don’t use triptans, “they’re not always effective or well tolerated. “They can cause severe headaches if taken in excess.”
He added that lasmiditan is safe for the heart but not effective, while gepants is not effective but does not cause abuse headaches and can be used in prevention. «No one is effective for everyone». It is his opinion that progress should be made to the right medicine, although he says that in Spain, the money for these medicines is limited.
Along the same line is David García Azorín, from the Headache Department of the University Hospital of Valladolid. “Although meta-analyses are valuable, their interpretation must be cautious because of the diversity of studies and methods.” It is known that new treatments are less effective, but provide benefits in some patients. Because, in his opinion, “the treatment must be personal.”
More critical is Robert Belvís, of the Evidence and Neuralgia Department at the Department of Neurology of the Hospital de la Santa Creu i Sant Pau in Barcelonawhich considered it risky for a meta-analysis to compare old trials of triptans with more recent studies of new drugs. “Without head-to-head studies, you can’t know which medicine is most effective.” It is known that triptans do not always work and it is necessary to change between them, but in Spain they will continue to be the first choice due to the lack of money for new drugs.
Pablo Irimia, a neurologist who specializes in the diagnosis and treatment of headaches in people, has the same opinion. University of Navarre Clinicindicating that a direct study between drugs would be designed to confirm these conclusions.
#Newer #migraine #medications #effective #classic