BackgroundAlthough migraine is a disabling neurological condition that causes important disability, it remains an area of underdiagnosis and undertreatment worldwide. The aim of this study was to depict the burden of the unmet medical needs in migraine treated with triptans in a large Italian population.MethodsA 2-year longitudinal analysis of migraineurs with unmet medical needs on treatment with triptans was performed. The studied cohort consisted of subjects with ≥4 triptan dose units per month, selected from the general population These patients were stratified into: possible Low-Frequency Episodic Migraine (pLF-EM: 4–9 triptan dose units per month), possible High-Frequency Episodic Migraine (pHF-EM: 10–14 triptan dose units per month) and possible Chronic Migraine (pCM:> 14 triptan dose units per month). The first follow-up year was analysed to describe the use of preventive therapies, the second year to describe the ≥50% reduction in triptan use.ResultsOf 10,270,683 adults, 8.0 per 1000 were triptan users and, of these, 38.2% were migraineurs with unmet medical needs, corresponding to 3.1 per 1000 adults. By stratifying for the number of triptan dose units per month, 72.3% were affected by pLF-EM, 17.4% by pHF-EM, and 10.3% by pCM. In this cohort, 19.1% of individuals used oral preventive drugs and 0.1% botulinum toxin. Triptan use reduction was found in 22.3% individuals of the cohort, decreasing with the intensification of need levels (25.8% pLF-EM, 13.6% pHF-EM, 12.0% pCM).ConclusionsThis real-life analysis underlined that the unmet medical needs concern a large part of patients treated with triptans and there is an undertreatment with preventive therapies whose benefit is insufficient, which may be due to the lack of effective preventive strategies, probably still reserved to severe patients. This study allows forecasting the actual impact of newest therapeutic strategies aimed to fill this gap.

中文翻译：

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一项关于曲坦类治疗偏头痛未满足医疗需求的真实世界研究：两年来大量意大利人口的流行率、预防性治疗和曲坦类药物使用调整

背景尽管偏头痛是一种导致严重残疾的致残性神经系统疾病，但它仍然是世界范围内诊断不足和治疗不足的领域。本研究的目的是描述在大量意大利人群中接受曲坦类药物治疗的偏头痛患者医疗需求未得到满足的负担。方法对使用曲坦类药物治疗的医疗需求未得到满足的偏头痛患者进行了为期 2 年的纵向分析。研究队列由每月 ≥ 4 个曲坦剂量单位的受试者组成，选自一般人群 这些患者被分层为：可能的低频发作性偏头痛（pLF-EM：每月 4-9 个曲坦剂量单位），可能的高-频发性偏头痛（pHF-EM：每月 10-14 个曲坦剂量单位）和可能的慢性偏头痛（pCM：> 14 个曲坦剂量单位/月）。对第一年随访描述预防性治疗的使用，第二年描述曲坦类药物使用减少≥50%。结果 10,270,683 名成人中，每 1000 人中有 8.0 人为曲坦类药物使用者，其中 38.2% 为偏头痛未满足的医疗需求，相当于每 1000 名成人 3.1 人。通过对每月曲坦剂量单位数进行分层，72.3% 受 pLF-EM 影响，17.4% 受 pHF-EM 影响，10.3% 受 pCM 影响。在该队列中，19.1% 的人使用口服预防药物和 0.1% 的肉毒杆菌毒素。在队列中 22.3% 的个体中发现曲坦类药物使用减少，随着需求水平的增加而减少（25.8% pLF-EM、13.6% pHF-EM、12.0% pCM）。结论这项现实生活分析强调，未满足的医疗需求涉及大部分接受曲坦类药物治疗的患者，并且预防性疗法治疗不足，其获益不足，这可能是由于缺乏有效的预防策略，可能仍保留给重症患者。耐心。这项研究可以预测旨在填补这一空白的最新治疗策略的实际影响。