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Studie bewertet Triptane nach Behandlungspräferenzen [Pharma]
11 Mai 05

Almogran, Maxalt und Relpax kommen dem idealen Triptan angeblich am Nächsten

Eine Studie hat die verfügbaren Triptane gemäß ihren Wirkungen und Nebenwirkungen mit den Behandlungspräferenzen der Betroffenen in Beziehung gesetzt und dann Empfehlungen erarbeitet, unter welchen Rahmenbedingungen welches Triptan vermutlich das beste ist.

Insgesamt kam die Studie zu dem Ergebnis, dass Almogran, Maxalt und Relpax dem idealen Triptan (d. h. ohne besondere Behandlungspräferenzen) am nächsten kamen:

Background: In treating migraine sufferers, physicians can choose from among seven triptans with different attributes.

Objective: To develop a system for selecting an oral triptan based on treatment priorities of migraine sufferers, neurologists, and primary care physicians (PCPs) in the United States, and evidence-based performance of triptans in clinical trials.

Methods: The TRIPSTAR project combines data on the treatment preferences of migraineurs and physicians with results from a meta- analysis of individual triptans, which evaluated their effectiveness on various clinical endpoints. Telephone interviews with migraine sufferers, neurologists, and PCPs were conducted to elicit individual views on the relative importance of a prespecified set of acute treatment outcomes. Four hundred and fifteen migraine sufferers, both triptan-experienced and triptan-naive, were interviewed. Also, 200 board-certified neurologists and 200 PCPs provided information on migraine patients from their clinical practice. A multiattribute decision model for selecting an oral triptan was constructed using attribute importance weights collected at telephone interview and the meta-analysis data, which were drawn from 53 clinical trials of 6 oral triptans.

Results: Efficacy attributes were rated significantly more important than tolerability or consistency in selecting an oral triptan, according to migraine sufferers and physicians. Freedom from cardiovascular adverse events was the most important tolerability attribute, according to migraine sufferers and physicians alike. Pain free at 1 h was the most important lower- level efficacy attribute for migraine sufferers, while sustained pain free was most important for physicians. When weighted treatment attributes were combined with meta-analysis data in a multi- attribute decision model, almotriptan 12.5mg, eletriptan 80 mg, and rizatriptan 10mg were significantly closer to the hypothetical ideal triptan than was sumatriptan 100 mg. Triptans selected by the model were generally closer to the patient-specific ideal triptan than were the triptans prescribed by physicians.

Conclusions: Almotriptan, eletriptan, and rizatriptan were the three triptans closest to the ideal, from the perspectives of migraine sufferers, PCPs, and neurologists alike. The TRIPSTAR model may be a potentially useful decision-support tool to help physicians select the triptan most likely to produce a successful outcome in migraine sufferers.

Weitere Infos finden sich hier.

Anmerkung von migraeneinformation.de:
Gemäß der Bewertung der gesetzlichen Krankenkassen in Deutschland ist Ascotop das wirkungsstärkste Triptan, denn ihm ist der höchste Festpreis zugebilligt worden.



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