Reacción a "New migraine drugs less effective than triptans, says meta-analysis"

Meta-analyses are not head-to-head studies, but we understand that it is the least ‘bad’ way to compare.

Not everything is based on efficacy of a treatment. Triptans are used less than they should/could be, but they are not effective in everyone:

• They are not effective in everyone; and to be effective they need to be administered within a therapeutic window that requires patient education.
• If taken in excess they generate a worsening of migraine (excess being >10 days per month, generating a headache due to overuse of analgesic medication).
• They are not always well tolerated.
• Lasmiditan is perhaps comparatively less effective, is also not always well tolerated and may, like triptans, facilitate the development of analgesic overuse, but it is cardiosafe.
• The gepants are perhaps less effective, but they offer new differences in that there is no evidence that they generate headache secondary to drug overuse, they have no therapeutic window and, in fact, their continued use helps to modulate the disease and they can also be used (for example, rimegepant) as a preventive treatment.
• And like triptans, gepants are also not effective for everyone.

What I mean by this is that migraine treatment must be prioritised. On a scientific level, now with more drugs available for the treatment of migraine attacks, we will have to develop ways to try to be able to offer the right treatment for each person at the right time, in other words, to develop precision medicine strategies.

Finally, as a comment, in Spain lasmiditan is only funded in some very specific situations, and gepants are not funded as a treatment for migraine attacks.