Triptans ‘most effective’ for migraine and should be first choice, say researchers

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By Emma Wilkinson

Triptans are the most effective treatment for migraine according to a large, detailed analysis that showed they outperform newer more expensive drugs.

The findings suggest that triptans are widely underused and guidelines should be updated to reflect their superiority compared with other treatments, the researchers concluded in the BMJ.

A comparison using data from 137 randomised controlled trials of almost 90,000 patients found that eletriptan, rizatriptan, sumatriptan, and zolmitriptan were the best options of all treatments when both efficacy and tolerability were taken into account.

They were also more effective than the more recently marketed and more expensive drugs lasmiditan, rimegepant, and ubrogepant, which were found to be on a par with paracetamol and most non-steroidal anti-inflammatory drugs.

All treatments had been shown in studies to be better than placebo at relieving pain but that does not help clinicians decide between the different options, the researchers from across Europe including the University of Oxford said.