Cheaper medicines can be just as effective to treat migraine attacks as more expensive drugs, according to a study published in the European Journal of Neurology.
Migraines are more than just headaches. Often, patients also experience nausea, vomiting, and light sensitivity. Migraines can be extremely debilitating and make it difficult for patients to carry out their daily activities.
Worryingly for these patients, finding a treatment that works well for them can take a long time. To make this process easier, a team of researchers from the Norwegian Center for Headache Research (NorHead) used data from the Norwegian Prescription Register from 2010 to 2020 to assess which medicines can help patients prevent migraines. The team measured the use of migraine drugs before and after patients started receiving specific preventive treatments and then assessed how long these patients stayed with these treatments. The study included results from over 100,000 participants.
“When the withdrawal of acute migraine medicines changed little after starting preventive medicines, or people stopped quickly on the preventive medicines, the preventive medicine was interpreted as having little effect. If the preventive medicine was used on long, uninterrupted periods, and we saw a decrease in the consumption of acute medicines, we interpreted the preventive medicine as having good effect”, said Professor Marte-Helen Bjørk at the Department of Clinical Medicine, University of Bergen.
As a general rule, patients are prescribed beta-blockers as the first choice to treat migraine attacks, but this study found that three medicines actually had better preventative effects: CGRP inhibitors, amitriptyline, and simvastatin. “The latter two medicines are also established medicines used for depression, chronic pain, and high cholesterol, respectively, while CGRP inhibitors are developed and used specifically for chronic migraine,” added Prof. Bjørk.
CGRP inhibitors are more expensive than the other two alternatives. In 2021, their reimbursement amounted to 500 million NOK (45 million Euros). This study shows that cheaper medicines can be just as effective in treating migraines as more expensive drugs. This can be important both for the patient group and the Norwegian health care system.
Given these promising results, the team at NorHead has already started working on a clinical trial to evaluate the effect of established cholesterol-lowering medicines as a preventive measure against chronic and episodic migraine.
Bjørk MH, Borkenhagen S, Oteiza F, Dueland AN, Sørgaard FE, Saether EM, Bugge C. Comparative retention and effectiveness of migraine preventive treatments: A nationwide registry-based cohort study. Eur J Neurol. 2024 Jan;31(1):e16062. doi: 10.1111/ene.16062. Epub 2023 Sep 27. PMID: 37754544