Triptans (Serotonin, 5-HT_1B/1D Agonists) in Migraine: Detailed Results and Methods of A Meta-Analysis of 53 Trials

Triptans are effective acute migraine medications that act on serotonin receptors. Seven different triptans will soon be available in 13 oral doses. This creates a need for evidence-based selection guidelines for clinicians. A meta-analysis of 53 trials involving 24,089 patients was conducted. The trials were double-blind, randomized, and controlled for oral triptans in migraine. Mean results for sumatriptan 100 mg showed a 59% headache response at two hours. Efficacy rates varied among triptans, with rizatriptan and almotriptan showing better results. Tolerability was generally good across all triptans. The study highlighted methodological issues related to trial designs and patient selection. Differences in efficacy and tolerability among triptans can be clinically significant. All triptans are contraindicated for patients with cardiovascular disease. This research provides valuable insights for optimizing migraine treatment strategies in clinical practice. Clinical relevance: This research suggests that triptans vary in efficacy and tolerability, guiding clinicians in choosing the best options for migraine patients.