A recent study presented at PAINWeek 2023 suggests that both over-the-counter (OTC) products and oral prescription medications can effectively relieve pain and provide freedom from migraine during episodes. The main treatments currently used for episodic migraine include analgesics, nonsteroidal anti-inflammatory drugs, triptans, ergots, and opioids.
The study, which involved 568 individuals living with migraine, found that 49% of participants relied solely on OTC products for migraine relief, while 23% used a combination of OTC and prescription products. Although new classes of oral prescription medications have been developed in recent years, such as gepants and selective 5-HT agonists, no direct comparisons have been made between these newer products and OTC options.
To address this gap, the researchers conducted an analysis of published studies on episodic migraine treatment. They compared the effectiveness of OTC products indicated for migraine treatment (specifically, acetaminophen/aspirin/caffeine and ibuprofen) to gepants and selective 5-HT agonists in relieving headache pain and providing freedom from pain two hours after dosage. Secondary endpoints included time to pain freedom, need for additional medications, sustained pain relief for 24 hours, and reduction in nausea, photophobia, and phonophobia.
The study found that both OTC and oral prescription products significantly improved primary endpoints of pain relief and pain freedom compared to placebo at the two-hour mark. Acetaminophen/aspirin/caffeine showed pain relief rates of 59.3% and pain freedom rates of 20.8%, while ibuprofen showed pain relief rates of 72.3% and pain freedom rates of 27.7%. Rates of pain relief for gepants and selective 5-HT agonists ranged from 59.3% to 62.1%. Rates of pain freedom ranged from 20.5% to 29.8%. Notably, ibuprofen had lower rates of pain relief and freedom compared to the other products.
The researchers concluded that OTC and newly approved oral prescription products demonstrated significant improvements in pain relief and freedom compared to placebo. They emphasized the convenience and affordability of OTC treatments compared to the newer oral prescription options. They believe that the use of OTC products should remain an important part of an integrated healthcare approach to treating episodic migraine.
Reference:
Mitra A, Petrusche R, Lee G. A retrospective evaluation of over-the-counter products versus recently approved oral prescription products for episodic migraine. Presented at: PAINWeek; September 5-8, 2023; Las Vegas, NV. (Source: Not provided)
