Physicians Ignore Triptan Cardiac Warnings in One Of Four Patients

by Rosemary Frei, MSc

New Orleans—It appears that physicians are now so comfortable with triptans that some are prescribing them for migraine patients who have associated cardiac risks. Nearly one-fourth of migraineurs with cardiac contraindications are given triptan prescriptions, according to a study of 2.5 million adult migraineurs in the MedAssurant Medical Outcomes Research for Effectiveness and Economics registry (MORE2).

A poster presented at the American Neurological Association’s 2011 annual meeting by a team from Thomas Jefferson University, Philadelphia, Merck Sharp & Dohme and MedAssurant showed that 22% of people with migraines and a cardiac contraindication for triptans nonetheless filled at least one triptan prescription in 2009. Furthermore, there were significant differences in this percentage across 10 health plans in the MORE2 registry, with some being far higher. The study was funded by Merck Sharp & Dohme.

“I frequently see patients who were either prescribed triptans when they should not have been, or were not told to stop them after developing a cardiac condition,” observed Gretchen Tietjen, MD, professor and chair of neurology, and director of the University of Toledo Medical Center’s Headache Treatment and Research Program in Toledo, Ohio, who was not involved in the study. “I think that by highlighting this phenomenon, this study will push practitioners to re-familiarize themselves with the triptans and the prescribing information. The study also points to the need for effective migraine meds in the cardiac population.”

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