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...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2021-02-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-021-83508-2 |
| _version_ | 1830301148128477184 |
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| 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 |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-12-19T08:42:33Z |
| format | Article |
| id | doaj.art-0edd85640e82420f91e4c08dc754ffef |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-12-19T08:42:33Z |
| publishDate | 2021-02-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-0edd85640e82420f91e4c08dc754ffef2022-12-21T20:28:54ZengNature PortfolioScientific Reports2045-23222021-02-011111810.1038/s41598-021-83508-2Real world effectiveness and tolerability of candesartan in the treatment of migraine: a retrospective cohort studyCarmen Sánchez-Rodríguez0Álvaro Sierra1Álvaro Planchuelo-Gómez2Enrique Martínez-Pías3Ángel L. Guerrero4David García-Azorín5Department of Medicine, University of ValladolidHeadache Unit, Department of Neurology, Hospital Clínico Universitario de ValladolidImaging Processing Laboratory, Universidad de ValladolidHeadache Unit, Department of Neurology, Hospital Clínico Universitario de ValladolidDepartment of Medicine, University of ValladolidHeadache Unit, Department of Neurology, Hospital Clínico Universitario de ValladolidAbstract 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.https://doi.org/10.1038/s41598-021-83508-2 |
| spellingShingle | 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 Scientific Reports |
| title | 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_short | 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 |
| url | https://doi.org/10.1038/s41598-021-83508-2 |
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