Key clinical point: Triptans, including eletriptan, rizatriptan, sumatriptan, and zolmitriptan, were more efficacious than newer and more expensive medications, such as lasmiditan and rimegepant, for the acute treatment of migraine.
Major findings: All active interventions were superior to placebo in achieving freedom from pain at 2 hours (odds ratio [OR], 1.73) with naratriptan and (OR, 5.19) for eletriptan. Eletriptan was the most effective for pain relief at two hours (OR, 1.46-3.01), followed by rizatriptan (OR, 1.59-2.44), sumatriptan (OR, 1.35-2.04), and zolmitriptan (OR, 1.47-1.96). For sustained pain freedom, eletriptan and ibuprofen were the most effective.
Study details: This network meta-analysis of 137 randomized controlled trials included 89,445 adults with migraine who received one of 17 drugs, including antipyretics, ditans, gepants, nonsteroidal anti-inflammatory drugs, and triptans, or placebo.
Disclosures: This study was funded by the National Institute for Health and Care Research Oxford Health Biomedical Research Centre and the Lundbeck Foundation. Several authors reported having ties with various sources.
Source: Karlsson WK, Ostinelli EG, Zhuang ZA, et al. Comparative effects of drug interventions for the acute management of migraine episodes in adults: Systematic review and network meta-analysis. BMJ. 2024;386:e080107. Source