Norwegian study looks at which medicines best prevent migraine

Migraine is greater than only a headache. Often the pain is accompanied by nausea, vomiting, light sensitivity, and sound sensitivity. Chronic migraine may be disabling and will prevent many, especially women, from contributing to working life.

Still, it often takes an extended time for migraine patients to search out a treatment that works well for them. Researchers on the Norwegian Center for Headache Research (NorHead) have used data from the Norwegian Prescription Register to take a look at which medicines best prevent migraine in people in Norway:

There has now been done lots of research on this subject before. This may increasingly weaken the standard of the treatment and increase the price of treatment for this patient group.”

Marte-Helen Bjørk, Study Leader, Professor, Department of Clinical Medicine, University of Bergen

Three medicines had higher effect than the primary selection of medicines.

The researchers used national register data from 2010 to 2020 to estimate treatment effect. They measured this by the consumption of acute migraine medicines before and after starting preventive treatment, and investigated how long the individuals with migraine used the several preventive treatments. A complete of over 100 thousand migraine patients were within the study.

“When the withdrawal of acute migraine medicines modified little after starting preventive medicines, or people stopped quickly on the preventive medicines, the preventive medicine was interpreted as having little effect. If the preventive medicine was used on long, uninterrupted periods, and we saw a decrease within the consumption of acute medicines, we interpreted the preventive medicine as having good effect”, Bjørk explains.

As a rule, so-called beta blockers are used as the primary selection to forestall migraine attacks, however the researchers found that especially three medicines had higher preventive effect than these: CGRP inhibitors, amitriptyline and simvastatin.

“The latter two medicines are also established medicines used for depression, chronic pain and high cholesterol, respectively, while CGRP inhibitors are developed and used specifically for chronic migraine”, says the professor.

Can have great significance for the price of health care.

CGRP inhibitors are costlier than the opposite medicines. In 2021 their reimbursement amounted to 500 million NOK (not including discounts given by pharma firms).

“Our evaluation shows that some established and cheaper medicines can have the same treatment effect because the costlier ones. This may increasingly be of great significance each for the patient group and Norwegian health care”, says Bjørk.

The researchers at NorHead have already began work on a big clinical study to measure the effect of established cholesterol-lowering medicines as a safety measure against chronic and episodic migraine.