ABSTRACT
Title
Pattern of triptan use and cardiovascular co-prescription: a pharmacoepidemiological study in Italy
Authors
C. Biagi1, E. Poluzzi1, G. Roberto1, A. Puccini2, A. Vaccheri1, R. D'Alessandro3, D. Motola1, and N. Montanaro1
1Dept. of Pharmacology, University of Bologna, Bologna, Italy;
2Drug Policy Service, Emilia Romagna Region Health Authority, Bologna, Italy
3Dept. of Neurology, University of Bologna, Italy
1Dept. of Pharmacology, University of Bologna, Bologna, Italy;
2Drug Policy Service, Emilia Romagna Region Health Authority, Bologna, Italy
3Dept. of Neurology, University of Bologna, Italy
Abstract
Triptans are a specific class of drugs for the treatment of acute episodes of migraine (Farmadati, ICDH 2004). Although clinical trials showed their favorable risk-benefit profile under appropriate criteria of use (Pascual et al., 2007), pattern of consumption in real life settings are poorly investigated (Panconesi et al. 2010).
We evaluate incidence, prevalence and patterns of triptan utilization with a special focus on subjects who also received cardiovascular drugs, considered as a deviation from appropriate triptan use.
We collected data on prescriptions reimbursed in the period 2006-2008 in Emilia Romagna. Patients receiving at least one prescription of triptans from January to December 2007 were divided in two groups: new users (without triptan prescriptions in 2006) and already in treatment. All subjects were followed for 12 months in terms of both triptan use and cardiovascular co-prescriptions.
One-year prevalence of triptan use was 0.8% while incidence was 0.4%. New users accounted for 47.5% of total users (34,915). The percentage of very frequent users (>120 and >170 dosage unit per year) was about double among already in treatment (26.6% and 16%) in comparison to new users (1% and 0.4%; p<0.01). Subjects starting with the lowest-dose of tablet formulation were more likely to interrupt therapy after their first prescription (p<0.01). Many users aged >65 received concomitant cardiovascular therapies: 36.6% among new users and 64.3% in already in treatment (p<0.01). In both groups, about 5% of elderly patients received co-prescriptions suggesting a high deviationfrom appropriate triptan use.
A higher percentage of abusers was detected in already treatment patients rather than new users. Moreover, a not negligible percentage of triptanrecipients belonged to not recommended age groups (£18 years and > 65) and presented cardiovascular contraindication.
CFT. Farmadati. (2011) Updated periodically.
ICDH: 2nd edition. (2004) Cephalalgia. 24, 9-160.
Pascual et al. (2007). Headache. 47, 1152-68.
Panconesi et al. (2010) Cephalalgia. 30, 576-81.
We evaluate incidence, prevalence and patterns of triptan utilization with a special focus on subjects who also received cardiovascular drugs, considered as a deviation from appropriate triptan use.
We collected data on prescriptions reimbursed in the period 2006-2008 in Emilia Romagna. Patients receiving at least one prescription of triptans from January to December 2007 were divided in two groups: new users (without triptan prescriptions in 2006) and already in treatment. All subjects were followed for 12 months in terms of both triptan use and cardiovascular co-prescriptions.
One-year prevalence of triptan use was 0.8% while incidence was 0.4%. New users accounted for 47.5% of total users (34,915). The percentage of very frequent users (>120 and >170 dosage unit per year) was about double among already in treatment (26.6% and 16%) in comparison to new users (1% and 0.4%; p<0.01). Subjects starting with the lowest-dose of tablet formulation were more likely to interrupt therapy after their first prescription (p<0.01). Many users aged >65 received concomitant cardiovascular therapies: 36.6% among new users and 64.3% in already in treatment (p<0.01). In both groups, about 5% of elderly patients received co-prescriptions suggesting a high deviationfrom appropriate triptan use.
A higher percentage of abusers was detected in already treatment patients rather than new users. Moreover, a not negligible percentage of triptanrecipients belonged to not recommended age groups (£18 years and > 65) and presented cardiovascular contraindication.
CFT. Farmadati. (2011) Updated periodically.
ICDH: 2nd edition. (2004) Cephalalgia. 24, 9-160.
Pascual et al. (2007). Headache. 47, 1152-68.
Panconesi et al. (2010) Cephalalgia. 30, 576-81.