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2016 ; 58
(ä): 37-40
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Predictors of Triptan Response in Pediatric Migraine
#MMPMID26968976
Johnson HF
; Goadsby PJ
; Gelfand AA
Pediatr Neurol
2016[May]; 58
(ä): 37-40
PMID26968976
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BACKGROUND: Migraine is common in children and adolescents and can be disabling.
Being able to predict which patients will respond to triptans based on their
clinical phenotype would be helpful. Adult data suggest cranial autonomic
symptoms and aura predict triptan response. This study examined clinical
predictors of triptan response in pediatric migraineurs. METHODS: This chart
review study included all patients less than 18 years old with migraine who were
seen at the University of California, San Francisco Headache Center in 2014.
Univariate ?(2) analyses were performed, followed by multivariate logistic
regression modeling. RESULTS: Of 127 pediatric migraineurs, 70 (55%) had chronic
migraine and 24 (19%) had aura. The majority (55%) had at least one cranial
autonomic symptom. Of 65 with triptan outcome data, 47 (73%) benefitted from a
triptan. In univariate analyses, triptan benefit was seen in 65% with chronic
migraine versus 88% with episodic migraine (P = 0.048), 67% with aura versus 74%
without (P = 0.66), and 70% with cranial autonomic symptom versus 74% without
(P = 0.76). In a multivariate logistic regression model, chronic migraine, aura,
and cranial autonomic symptom were not statistically significant predictors of
triptan benefit: chronic migraine: 0.25 (0.06-1.04); aura: 0.65 (0.09-4.45);
cranial autonomic symptom: 0.75 (0.22-2.52). CONCLUSIONS: In univariate analysis,
individuals with chronic migraine were less likely to benefit from triptans. In
contrast to what has been documented in adults, cranial autonomic symptoms and
aura did not predict triptan response, although our small sample size limited the
study's power. Larger pediatric studies are needed, and future pediatric triptan
trials should provide response rates stratified by clinical variables such as
aura.
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