{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T19:16:20Z","timestamp":1777490180864,"version":"3.51.4"},"reference-count":27,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2024,9,1]],"date-time":"2024-09-01T00:00:00Z","timestamp":1725148800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Cephalalgia"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Triptans revolutionized the acute treatment of migraine; however, varied responses to triptans, as a result of poor efficacy and tolerability, are reported. A standardized definition of triptan non-response was recently proposed by the European Headache Federation (EHF). There is currently limited data available on the prevalence of triptan non-response.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used clinic letters over a two-year duration to evaluate the triptan response and triptan efficacy or tolerability failure, or both, in a London-based tertiary headache service.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In total, 419 adult migraine patients (females: 83.8%, age: 46\u2009\u00b1\u200918\u00a0years, chronic migraine: 88.5%) were included in a service evaluation. In line with the EHF definitions, \u201ctriptan non-response\u201d was seen in 63.8% of patients (264\/414), whereas 37.7% of patients (156\/414) had failed at least two triptans (EHF \u201ctriptan resistant\u201d) and 4.6% of patients (19\/414) had failed at least three triptans, including a subcutaneous formulation (EHF \u201ctriptan refractory\u201d). Notably, 21.3% of patients (88\/414) had failed at least three triptans inclusive and exclusive of subcutaneous triptan use. Advancing age ( p\u2009&lt;\u20090.001) and the presence of medication overuse ( p\u2009=\u20090.006) increased the probability of triptan response, whereas an increased number of failed preventives ( p\u2009&lt;\u20090.001) and the use of calcitonin gene-related peptide monoclonal antibodies ( p\u2009=\u20090.022) increased the probability of triptan non-response. The largest proportion of patients responded to eletriptan (49.5%), followed by nasal zolmitriptan (44.4%) and rizatriptan (35.7%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our findings highlight an alarming prevalence of triptan non-response among adult migraineurs receiving treatment in a London-based tertiary headache service. It is imperative for clinicians to explore methods to optimize acute medication efficacy, whether this comprises changing to a triptan with a superior response rate, advocating for early intervention or considering alternative acute medication classes, such as gepants or ditans.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03331024241278911","type":"journal-article","created":{"date-parts":[[2024,9,9]],"date-time":"2024-09-09T04:27:03Z","timestamp":1725856023000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Triptan non-response in a London tertiary headache centre: What can we learn? A retrospective study"],"prefix":"10.1177","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3330-0451","authenticated-orcid":false,"given":"Robyn-Jenia","family":"Wilcha","sequence":"first","affiliation":[{"name":"NIHR King\u2019s Clinical Research Facility, SLaM Biomedical Research Centre, and Wolfson Sensory, Pain and Regeneration Centre, King\u2019s College London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3260-5904","authenticated-orcid":false,"given":"Peter J.","family":"Goadsby","sequence":"additional","affiliation":[{"name":"NIHR King\u2019s Clinical Research Facility, SLaM Biomedical Research Centre, and Wolfson Sensory, Pain and Regeneration Centre, King\u2019s College London, London, UK"},{"name":"Department of Neurology, University of California, Los Angeles, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2024,9,9]]},"reference":[{"key":"bibr1-03331024241278911","doi-asserted-by":"publisher","DOI":"10.1016\/S0301-0082(00)00010-1"},{"key":"bibr2-03331024241278911","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(01)06711-3"},{"key":"bibr3-03331024241278911","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-6632.1990.tb16912.x"},{"key":"bibr4-03331024241278911","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-021-00328-4"},{"key":"bibr5-03331024241278911","doi-asserted-by":"publisher","DOI":"10.1177\/0333102413480756"},{"key":"bibr6-03331024241278911","doi-asserted-by":"publisher","DOI":"10.1046\/j.1526-4610.2001.01192.x"},{"key":"bibr7-03331024241278911","doi-asserted-by":"publisher","DOI":"10.1016\/j.pharmthera.2020.107528"},{"key":"bibr8-03331024241278911","doi-asserted-by":"publisher","DOI":"10.1177\/0333102419889350"},{"key":"bibr9-03331024241278911","doi-asserted-by":"publisher","DOI":"10.1177\/03331024221141686"},{"key":"bibr10-03331024241278911","doi-asserted-by":"publisher","DOI":"10.1111\/head.14089"},{"key":"bibr11-03331024241278911","doi-asserted-by":"publisher","DOI":"10.1186\/s10194-022-01502-z"},{"key":"bibr12-03331024241278911","doi-asserted-by":"publisher","DOI":"10.1186\/s10194-023-01676-0"},{"key":"bibr13-03331024241278911","doi-asserted-by":"publisher","DOI":"10.1177\/03331024221143773"},{"key":"bibr14-03331024241278911","doi-asserted-by":"publisher","DOI":"10.1177\/0333102417738202"},{"key":"bibr15-03331024241278911","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-2982.2004.00691.x"},{"key":"bibr16-03331024241278911","doi-asserted-by":"publisher","DOI":"10.1111\/head.14363"},{"key":"bibr17-03331024241278911","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4610.2006.00505.x"},{"key":"bibr18-03331024241278911","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4610.2005.05151.x"},{"key":"bibr19-03331024241278911","doi-asserted-by":"publisher","DOI":"10.1046\/j.1526-4610.2000.00069.x"},{"key":"bibr20-03331024241278911","doi-asserted-by":"publisher","DOI":"10.1046\/j.1468-2982.2003.00554.x"},{"key":"bibr21-03331024241278911","doi-asserted-by":"publisher","DOI":"10.1046\/j.1526-4610.2000.00082.x"},{"key":"bibr22-03331024241278911","doi-asserted-by":"publisher","DOI":"10.1177\/0333102413508661"},{"key":"bibr23-03331024241278911","doi-asserted-by":"publisher","DOI":"10.1046\/j.1468-2982.2002.00404.x"},{"key":"bibr24-03331024241278911","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-2982.2007.01457.x"},{"key":"bibr25-03331024241278911","doi-asserted-by":"publisher","DOI":"10.1046\/j.1468-1331.1999.610043.x"},{"key":"bibr26-03331024241278911","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.49.5.1225"},{"key":"bibr27-03331024241278911","doi-asserted-by":"crossref","unstructured":"Kosinski M, Bayliss MS, Bjorner JB, et al. A six-item short-form survey for measuring headache impact: the HIT-6. Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation.\n                      Qual Life Res\n                      2003;12:963-974.","DOI":"10.1023\/A:1026119331193"}],"container-title":["Cephalalgia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/03331024241278911","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/03331024241278911","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/03331024241278911","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T14:46:30Z","timestamp":1777387590000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/03331024241278911"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9]]},"references-count":27,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2024,9]]}},"alternative-id":["10.1177\/03331024241278911"],"URL":"https:\/\/doi.org\/10.1177\/03331024241278911","relation":{},"ISSN":["0333-1024","1468-2982"],"issn-type":[{"value":"0333-1024","type":"print"},{"value":"1468-2982","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9]]},"article-number":"03331024241278911"}}