Triptans are safe for migraine in pregnancy

Findings of a study presented at the recently concluded American Headache Society AHS 2017 Scottsdale Headache Symposium in Phoenix Arizona show that triptans are not major teratogens when administered for migraine treatment during pregnancy. The study further says that when compellingly needed during pregnancy sumatriptan as the best-studied triptan appears an acceptable treatment option.The study has been published online July 31 in Cephalalgia.

A migraine is a common disorder among women of childbearing age. Triptan medications are effective and commonly used to treat migraines during pregnancy. However, the reproductive safety of this group of drugs has not yet been confirmed. Antimigraine medication is commonly used in women of childbearing age, and with up to 50% of pregnancies unplanned, unintended fetal exposure to the drugs is common.

Dr.Kevin Spielmann and associates in a prospective observational cohort study assessed the impact of triptan exposure on pregnancy outcome.The researchers enrolled 432 pregnant women exposed to triptans by the German Embryotox system. Pregnancy outcomes were compared with a migraine and a non-migraine comparison cohort. Primary objectives were major birth defects and spontaneous abortion; secondary endpoints were preterm delivery, birth weight, pregnancy complications and the rate of electively terminated pregnancies.

It was found that as compared to a non-migraine cohort the rates of major birth defects (OR_adj 0.84; 95% CI 0.4–1.9), spontaneous abortions (OR_adj 1.20; 95% CI 0.9–1.7), preterm delivery (OR_adj 1.01; 95% CI 0.7–1.5), and preeclampsia (OR_adj 1.33; 95% CI 0.7–2.5) were not increased in triptan-exposed pregnancies.

The researchers concluded that triptans are not major teratogens. When compellingly needed during pregnancy, sumatriptan as the best-studied triptan appears an acceptable treatment option. A detailed fetal ultrasound should be offered in cases of first-trimester exposure to less well-studied triptans.

For more details click on the link: DOI: 10.1177/0333102417724152