Real world effectiveness and tolerability of candesartan in the treatment of migraine: a retrospective cohort study

Abstract To date, two randomized, controlled studies support the use of candesartan for migraine prophylaxis but with limited external validity. We aim to evaluate the effectiveness and tolerability of candesartan in clinical practice and to explore predictors of patient response. Retrospective coho...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Carmen Sánchez-Rodríguez, Álvaro Sierra, Álvaro Planchuelo-Gómez, Enrique Martínez-Pías, Ángel L. Guerrero, David García-Azorín
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/0edd85640e82420f91e4c08dc754ffef
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:0edd85640e82420f91e4c08dc754ffef
record_format	dspace
spelling	oai:doaj.org-article:0edd85640e82420f91e4c08dc754ffef2021-12-02T14:04:00ZReal world effectiveness and tolerability of candesartan in the treatment of migraine: a retrospective cohort study10.1038/s41598-021-83508-22045-2322https://doaj.org/article/0edd85640e82420f91e4c08dc754ffef2021-02-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-83508-2https://doaj.org/toc/2045-2322Abstract To date, two randomized, controlled studies support the use of candesartan for migraine prophylaxis but with limited external validity. We aim to evaluate the effectiveness and tolerability of candesartan in clinical practice and to explore predictors of patient response. Retrospective cohort study including all patients with migraine who received candesartan between April 2008-February 2019. The primary endpoint was the number of monthly headache days during weeks 8–12 of treatment compared to baseline. Additionally, we evaluated the frequency during weeks 20–24. We analysed the percentage of patients with 50% and 75% response rates and the retention rates after three and 6 months of treatment. 120/4121 patients were eligible, aged 45.9 [11.5]; 100 (83.3%) female. Eighty-four patients (70%) had chronic migraine and 53 (42.7%) had medication-overuse headache. The median number of prior prophylactics was 3 (Inter-quartile range 2–5). At baseline, patients had 20.5 ± 8.5 headache days per month, decreasing 4.3 ± 8.4 days by 3 months (weeks 12–16) and by 4.7 ± 8.7 days by 6 months (paired Student’s t-test, p < 0.001). The percentage of patients with a 50% response was 32.5% at 3 months and 31.7% at 6 months, while the retention rate was 85.0% and 58.3%. The number of prior treatments (Odds ratio 0.79, 95% CI 0.64–0.97) and the presence of daily headache (Odds ratio 0.39, 95% CI 0.16–0.97) were associated with a lower probability of response. Candesartan showed beneficial effects in the preventive treatment of migraine in clinical practice, including patients with chronic migraine, medication-overuse headache and resistance to prior prophylactics.Carmen Sánchez-RodríguezÁlvaro SierraÁlvaro Planchuelo-GómezEnrique Martínez-PíasÁngel L. GuerreroDavid García-AzorínNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Carmen Sánchez-Rodríguez Álvaro Sierra Álvaro Planchuelo-Gómez Enrique Martínez-Pías Ángel L. Guerrero David García-Azorín Real world effectiveness and tolerability of candesartan in the treatment of migraine: a retrospective cohort study
description	Abstract To date, two randomized, controlled studies support the use of candesartan for migraine prophylaxis but with limited external validity. We aim to evaluate the effectiveness and tolerability of candesartan in clinical practice and to explore predictors of patient response. Retrospective cohort study including all patients with migraine who received candesartan between April 2008-February 2019. The primary endpoint was the number of monthly headache days during weeks 8–12 of treatment compared to baseline. Additionally, we evaluated the frequency during weeks 20–24. We analysed the percentage of patients with 50% and 75% response rates and the retention rates after three and 6 months of treatment. 120/4121 patients were eligible, aged 45.9 [11.5]; 100 (83.3%) female. Eighty-four patients (70%) had chronic migraine and 53 (42.7%) had medication-overuse headache. The median number of prior prophylactics was 3 (Inter-quartile range 2–5). At baseline, patients had 20.5 ± 8.5 headache days per month, decreasing 4.3 ± 8.4 days by 3 months (weeks 12–16) and by 4.7 ± 8.7 days by 6 months (paired Student’s t-test, p < 0.001). The percentage of patients with a 50% response was 32.5% at 3 months and 31.7% at 6 months, while the retention rate was 85.0% and 58.3%. The number of prior treatments (Odds ratio 0.79, 95% CI 0.64–0.97) and the presence of daily headache (Odds ratio 0.39, 95% CI 0.16–0.97) were associated with a lower probability of response. Candesartan showed beneficial effects in the preventive treatment of migraine in clinical practice, including patients with chronic migraine, medication-overuse headache and resistance to prior prophylactics.
format	article
author	Carmen Sánchez-Rodríguez Álvaro Sierra Álvaro Planchuelo-Gómez Enrique Martínez-Pías Ángel L. Guerrero David García-Azorín
author_facet	Carmen Sánchez-Rodríguez Álvaro Sierra Álvaro Planchuelo-Gómez Enrique Martínez-Pías Ángel L. Guerrero David García-Azorín
author_sort	Carmen Sánchez-Rodríguez
title	Real world effectiveness and tolerability of candesartan in the treatment of migraine: a retrospective cohort study
title_short	Real world effectiveness and tolerability of candesartan in the treatment of migraine: a retrospective cohort study
title_full	Real world effectiveness and tolerability of candesartan in the treatment of migraine: a retrospective cohort study
title_fullStr	Real world effectiveness and tolerability of candesartan in the treatment of migraine: a retrospective cohort study
title_full_unstemmed	Real world effectiveness and tolerability of candesartan in the treatment of migraine: a retrospective cohort study
title_sort	real world effectiveness and tolerability of candesartan in the treatment of migraine: a retrospective cohort study
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/0edd85640e82420f91e4c08dc754ffef
work_keys_str_mv	AT carmensanchezrodriguez realworldeffectivenessandtolerabilityofcandesartaninthetreatmentofmigrainearetrospectivecohortstudy AT alvarosierra realworldeffectivenessandtolerabilityofcandesartaninthetreatmentofmigrainearetrospectivecohortstudy AT alvaroplanchuelogomez realworldeffectivenessandtolerabilityofcandesartaninthetreatmentofmigrainearetrospectivecohortstudy AT enriquemartinezpias realworldeffectivenessandtolerabilityofcandesartaninthetreatmentofmigrainearetrospectivecohortstudy AT angellguerrero realworldeffectivenessandtolerabilityofcandesartaninthetreatmentofmigrainearetrospectivecohortstudy AT davidgarciaazorin realworldeffectivenessandtolerabilityofcandesartaninthetreatmentofmigrainearetrospectivecohortstudy
_version_	1718392004928339968

Real world effectiveness and tolerability of candesartan in the treatment of migraine: a retrospective cohort study

Ejemplares similares