The latest treatments for migraines offer little benefit compared with traditional painkillers, a large study published Thursday found.
The study, published in the British Medical Journal, concluded that “eletriptan, rizatriptan, sumatriptan and zolmitriptan are more effective than the more expensive newer drugs currently on the market, lasmiditan, rimegepant and ubrogepant.”
The study focused only on medications used as pain relievers for migraine headaches, and did not address drugs that are a primary treatment to prevent or reduce headache attacks.
The benefits of different treatments for migraine, a very common disease that affects more than a billion people worldwide, are still unclear. Classic painkillers, aspirin and ibuprofen, have been prescribed for decades, in addition to a group of more effective treatments, triptans.
In recent years, a new generation of drugs has been added to the above treatments, some of which are from the “gepant” group, such as rimegepant, sold as Fedora by Pfizer, ubrogepant, sold as Uprilvy by AbbVie, and lasmiditan, which has a different mechanism of action and is sold as Rifao by Eli Lilly.
Migraine drugs are important to the pharmaceutical industry because they generate profits, and in 2022 Pfizer bought Biohaven, the company that developed the drug rimegepant, for about $10 billion.
All of these drugs were generally tested against a placebo.
The importance of the new study lies in the fact that it looked at about two hundred trials of this type to compare drugs.
Ultimately, “even if the sale of lasmiditan, rimegepant, and ubrogepant provides additional options for treating migraine attacks, the high cost of these new drugs and the significant side effects of lasmiditan in some people make them more likely to be considered a third-line treatment option,” the researchers concluded.
The recommendations urge that triptans be considered first because they are underused relative to their effectiveness. If they are not desirable because of the cardiovascular risks associated with them in some patients, it is better to turn to traditional pain relievers such as aspirin and ibuprofen.