Long-term treatment patterns of prophylactic and acute migraine medications and incidence of opioid-related adverse events in patients with migraine

Cephalalgia : an International Journal of Headache
Machaon M K BonafedeFei Xue

Abstract

To describe long-term treatment patterns in migraine patients initiating prophylactic therapy and to evaluate acute medication use and adverse events associated with opioids. This study used the 2005-2014 IBM MarketScan® databases to evaluate migraine patients initiating prophylactic medication. Outcome measures included persistence with prophylactic migraine medications over 2-5 years. Acute medication use and gastrointestinal-related adverse events and opioid abuse following opioid use were evaluated. Cox proportional hazards models were used to evaluate predictors of non-persistence and predictors of gastrointestinal-related AEs and opioid abuse associated with long-term opioid use. In total, 147,832 patients were analyzed. Non-persistence was observed in 90% of patients; 39% switched, 30% restarted, and 31% discontinued treatment. Over the follow-up, 59.9% of patients received triptans, 66.6% non-steroidal anti-inflammatory drugs, 77.4% opioids, and 2.6% ergotamines. Among opioid users, 16.6% experienced nausea/vomiting, 12.2% had constipation, and 10.4% had diarrhea. Opioid abuse was reported in <1% of opioid users. Gastrointestinal-related adverse events increased with increasing number of days' supply of opioids. Non-per...Continue Reading

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Citations

Oct 13, 2020·Current Medical Research and Opinion·Valentina PerroneLuca Degli Esposti
Jun 16, 2021·JAMA : the Journal of the American Medical Association·Juliana H VanderPluymZhen Wang
Jul 22, 2021·Arquivos de neuro-psiquiatria·Aline Vitali da SilvaRegina Célia Poli-Frederico
Oct 15, 2021·The Journal of Headache and Pain·Emily C McKinleyMichael E Farkouh

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Methods Mentioned

BETA
prophylactic therapy

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