Aldehaim Fahad M, Alruways Abdulaziz A, Alfarhan Abdulaziz A, Almunyif Saleh N, Alhusainy Abdulmajeed Z, Albahli Omar H, Almutairi Basil A, Alotaibi Meshari M, Alotaibi Abdulaziz M, Alotaibi Anas E, Aldalbahi Sultan S, Shabbir Muhammad, Alammar Muath A
From the Department of Internal Medicine (Aldehaim, Alhusainy, Albahli, M. Alotaibi, A.M Alotaibi, A.E Alotaibi, Aldalbahi) Dawadmi College of Medicine, Shaqra University, Dawadmi; from the Department of Internal Medicine (Alruways, Alfarhan, Almunyif, Almutairi, Shabbir), College of Medicine, Shaqra University, Shaqra; and from the Department of Family Medicine (Alammar), Shaqra Collage of Medicine, Shaqra University, Shaqra, Kingdom of Saudi Arabia.
Saudi Med J. 2025 Jun;46(6):608-616. doi: 10.15537/smj.2025.46.6.20250106.
To investigate the relationship between ischemic events and triptan use in patients having ischemic risk factors and evaluate the safety profile of these medications in vulnerable individuals.
A detailed search was done using Web of Science, Google Scholar, PubMed, and Medline, up to December 2024. Inclusion criteria encompassed studies focusing on triptan use in individuals having predisposing ischemic risk factors and comparing the incidence of ischemic events between those who use triptans and those who do not. Studies were excluded if they targeted patients without ischemic risk factors, did not assess triptan use, or lacked a comparative analysis between users of triptans and non-users.
From an initial pool of 1,615 articles, f4 studies with a total sample size of 426,840 were involved in the study. The analysis revealed no significant statistical relationship between triptan use and ischemic events in patients with ischemic risk factors. Subgroup analysis of Ischemic Stroke (95% CI=0.70-8.78; =0.16, I=97.7%), Myocardial Infarction (95% CI = 0.44-2.39; =0.95, I= 96.1%) and All-cause Mortality events (95% CI=0.33-1.58; =0.44, I=98.8%).
Our findings indicate that the use of triptan is not linked to a higher risk of ischemic events, indicating that triptans can be a safe therapeutic option for managing migraines in patients with ischemic risk factors. Nevertheless, Additional research is required to assess the long-term safety of triptans, particularly in high-risk populations. Limitations include the inclusion of only four studies, a limited body of literature available for comparison, and discrepancies in follow-up durations across the included studies..
探讨有缺血风险因素的患者中缺血事件与曲坦类药物使用之间的关系,并评估这些药物在易患人群中的安全性。
截至2024年12月,使用科学网、谷歌学术、PubMed和Medline进行了详细检索。纳入标准包括关注有缺血性危险因素个体使用曲坦类药物的研究,并比较使用曲坦类药物者与未使用者之间缺血事件的发生率。如果研究针对无缺血风险因素的患者、未评估曲坦类药物使用情况或缺乏曲坦类药物使用者与非使用者之间的比较分析,则将其排除。
从最初的1615篇文章中,选取了4项研究,总样本量为426,840。分析显示,有缺血风险因素的患者使用曲坦类药物与缺血事件之间无显著统计学关系。缺血性卒中(95%CI=0.70-8.78;P=0.16,I²=97.7%)、心肌梗死(95%CI = 0.44-2.39;P=0.95,I²= 96.1%)和全因死亡事件(95%CI=0.33-1.58;P=0.44,I²=98.8%)的亚组分析。
我们的研究结果表明,使用曲坦类药物与更高的缺血事件风险无关,这表明曲坦类药物对于有缺血风险因素的偏头痛患者来说是一种安全的治疗选择。然而,需要进一步研究来评估曲坦类药物的长期安全性,特别是在高危人群中。局限性包括仅纳入了四项研究、可供比较的文献有限以及纳入研究的随访时间存在差异。