Priorities for triptan treatment attributes and the implications for selecting an oral triptan for acute migraine: A study of US primary care physicians (the TRIPSTAR project)

F. Michael Cutrer, Peter J. Goadsby, Michel D. Ferrari, Richard B. Lipton, David William Dodick, Douglas McCrory, Paul Williams

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Physicians treating patients with migraine can now choose from among 7 triptans, which differ on a range of attributes that may be important for treatment selection. The aims of this study were to determine the relative importance of treatment attributes of the available triptans and assess their impact on deciding the most appropriate treatment for a particular patient with migraine. As part of the TRIPSTAR project, US primary care physicians were surveyed to elicit their views on the relative importance of a prespecified set of treatment attributes for making treatment choices in clinical practice. The treatment attributes assessed were those for which data from controlled clinical trials were available for subsequent comparison. The resulting attribute-importance weights were then combined with data on the performance of individual triptans across these attributes in a multiattribute decision model to assist selection of an oral triptan. Efficacy attributes were considered more important than tolerability or consistency of effect in selecting an oral triptan. For triptan-naive but not triptan-experienced patients, tolerability was considered significantly more important than consistency (30% [95% CI, 27%-34%] vs 21% [19%-24%]). Sustained pain-free status and freedom from cardiovascular (chest) adverse events were the most important efficacy and tolerability attributes for both patient categories. When the relative importance of the treatment attributes was combined in a multiattribute decision model with meta-analysis data from controlled trials, almotriptan, eletriptan, and rizatriptan were significantly closer to the hypothetical ideal triptan than the reference product, sumatriptan 100 mg. Multiattribute decision-making models (such as that used in the TRIPSTAR project) that determine and apply the relative importance of treatment attributes to drug selection have considerable potential value as a decision support tool in the treatment of acute migraine.

Original languageEnglish (US)
Pages (from-to)1533-1545
Number of pages13
JournalClinical Therapeutics
Volume26
Issue number9
DOIs
StatePublished - Sep 2004

Fingerprint

Tryptamines
Primary Care Physicians
Migraine Disorders
Therapeutics
Sumatriptan
Controlled Clinical Trials
Meta-Analysis
Decision Making
Thorax
Physicians
Weights and Measures

Keywords

  • decision model
  • migraine
  • treatment
  • triptans

ASJC Scopus subject areas

  • Pharmacology

Cite this

Priorities for triptan treatment attributes and the implications for selecting an oral triptan for acute migraine : A study of US primary care physicians (the TRIPSTAR project). / Cutrer, F. Michael; Goadsby, Peter J.; Ferrari, Michel D.; Lipton, Richard B.; Dodick, David William; McCrory, Douglas; Williams, Paul.

In: Clinical Therapeutics, Vol. 26, No. 9, 09.2004, p. 1533-1545.

Research output: Contribution to journalArticle

Cutrer, F. Michael ; Goadsby, Peter J. ; Ferrari, Michel D. ; Lipton, Richard B. ; Dodick, David William ; McCrory, Douglas ; Williams, Paul. / Priorities for triptan treatment attributes and the implications for selecting an oral triptan for acute migraine : A study of US primary care physicians (the TRIPSTAR project). In: Clinical Therapeutics. 2004 ; Vol. 26, No. 9. pp. 1533-1545.
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