Tatsumoto Muneto, Hirata Koichi, Nakayama Takeo, Yamato Kentaro, Sano Hiromi, Inuyama Lyo
Headache Center, Dokkyo Medical University Hospital, Tochigi, Japan.
Department of Neurology, Dokkyo Medical University, Tochigi, Japan.
Brain Behav. 2024 Dec;14(12):e70184. doi: 10.1002/brb3.70184.
This study aimed to investigate seasonal differences in migraine onset in Japan and associated trends in the prescription of triptan.
The relationship between seasonal changes and the onset of migraine remains largely unknown.
We combined the large-scale medical claims data in Japan with city-level meteorological data presented by the Japan Weather Association. The study period was from January 2018 to December 2019. We included patients aged 18-74 years and diagnosed with migraine who had been prescribed triptans in 2018. Patients were categorized into four groups according to the seasons when they were prescribed medicines: winter (January-March), spring (April-June), summer (July-September), and autumn (October-December). Migraine onsets were defined by the time of triptan prescription. The least-square mean differences between the seasons were estimated with linear mixed-effects models for repeated measures, adjusting for the following covariates: sex, age, acute migraine medications, and medications for migraine prevention, comorbidities that can induce migraine, other comorbidities, and the estimated age of menopause in females.
We analyzed data of 12,986 patients in 2019 after triptan had been prescribed (female 74.1%). The mean age was 44.1 years. The mean number of amounts of prescriptions comprised 2.12 tablets/month in spring and summer, whereas there were only 2.09 tablets/month in autumn and 2.00 tablets/month in winter. The amount of triptan prescribed in winter was lower than in spring (β = -0.117; 95% confidence interval [CI]: -0.169 to -0.065).
The study results suggest that seasons can have an impact on the onset of migraine; thus, clinicians may advise patients to take preventive actions, including self-care and drug therapies, from the winter stage. This should be done in order to reduce the number of migraine onsets in high-risk season (spring) regardless of region.
本研究旨在调查日本偏头痛发作的季节差异以及曲坦类药物处方的相关趋势。
季节变化与偏头痛发作之间的关系在很大程度上仍不清楚。
我们将日本的大规模医疗理赔数据与日本气象协会提供的城市级气象数据相结合。研究期间为2018年1月至2019年12月。我们纳入了年龄在18 - 74岁之间、2018年被诊断为偏头痛且已开具曲坦类药物处方的患者。根据开药季节将患者分为四组：冬季（1月至3月）、春季（4月至6月）、夏季（7月至9月）和秋季（10月至12月）。偏头痛发作由曲坦类药物处方时间定义。采用重复测量的线性混合效应模型估计季节间的最小二乘均值差异，并对以下协变量进行调整：性别、年龄、急性偏头痛药物、偏头痛预防药物、可诱发偏头痛的合并症、其他合并症以及女性的估计绝经年龄。
2019年在开具曲坦类药物后，我们分析了12986例患者的数据（女性占74.1%）。平均年龄为44.1岁。春季和夏季的平均处方量为每月2.12片，而秋季为每月2.09片，冬季为每月2.00片。冬季开具的曲坦类药物量低于春季（β = -0.117；95%置信区间[CI]：-0.169至-0.065）。
研究结果表明季节可能对偏头痛发作有影响；因此，临床医生可能建议患者从冬季阶段开始采取预防措施，包括自我护理和药物治疗。无论地区如何，都应这样做以减少高危季节（春季）偏头痛发作的次数。
