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Background <p>Migraine is a major cause of population ill health, with an estimated global prevalence of approximately 14–15%. However, given the limited research on the associations between specific migraine medications and adverse cerebrovascular events, this study aimed to investigate these relationships and their impact on cerebrovascular risk.</p> Methods <p>This study utilized data from the global pharmacovigilance database, which covers 170 countries from 1968 to 2024. We examined the reporting frequency of adverse cerebrovascular events with 10 migraine medications, with analysis stratified by sex and age. The information component (IC) was calculated using a Bayesian method, while the reporting odds ratio (ROR) was calculated using a frequentist approach to compare reported versus non-reported outcomes.</p> Results <p>Among the more than 140 million adverse drug events, 6,080 cases were identified as adverse cerebrovascular events associated with migraine-specific medications. Significant associations with cerebrovascular diseases were observed in both males (ROR, 1.24 [95% CI, 1.19–1.30]; IC 0.31 [IC<sub>0.25</sub>, 0.24]) and females (1.73 [1.67–1.79]; 0.78 [0.72]), with most age groups showing significance, except for those 75&#xa0;years and older. Among the 10 medication categories, 6 categories were associated with adverse cerebrovascular diseases: CGRP antagonists (ROR,&#xa0;1.22 [95% CI,&#xa0;1.12–1.33]; IC,&#xa0;0.28 [IC<sub>0.25</sub>,0.14]), ergot alkaloids (3.66 [2.97–4.51]; 1.84 [1.49]), 5-HT₁ receptor agonists (3.33 [2.97–4.51]; 1.72 [1.59]), beta-blockers (2.03 [1.94–2.13]; 1.02 [0.94]), calcium channel blockers (1.46 [1.30–1.64]; 0.54 [0.34]), and clonidine (2.18 [2.04–2.33]; 1.11 [1.00]).</p> Conclusion <p>This study found that commonly used migraine medications are significantly associated with an increased risk of cerebrovascular diseases, highlighting the need for careful patient evaluation and selection.</p>

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Disproportionality analysis from World Health Organization data on migraine-specific medications and cerebrovascular diseases

  • 期刊论文

  • 发表日期：

    2025年2月24日

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  • Jaehyeong Cho,
  • Hyesu Jo,
  • Jaeyu Park,
  • Kyeongmin Lee,
  • Hayeon Lee,
  • Soeun Kim,
  • Yejun Son,
  • Jeongseon Oh,
  • Jinyoung Jeong,
  • Sooji Lee,
  • Jiyeon Oh,
  • Hanseul Cho,
  • Jee Myung Yang,
  • Ho Geol Woo,
  • Dong Keon Yon,
  • Lee Smith

摘要

Background

Migraine is a major cause of population ill health, with an estimated global prevalence of approximately 14–15%. However, given the limited research on the associations between specific migraine medications and adverse cerebrovascular events, this study aimed to investigate these relationships and their impact on cerebrovascular risk.

Methods

This study utilized data from the global pharmacovigilance database, which covers 170 countries from 1968 to 2024. We examined the reporting frequency of adverse cerebrovascular events with 10 migraine medications, with analysis stratified by sex and age. The information component (IC) was calculated using a Bayesian method, while the reporting odds ratio (ROR) was calculated using a frequentist approach to compare reported versus non-reported outcomes.

Results

Among the more than 140 million adverse drug events, 6,080 cases were identified as adverse cerebrovascular events associated with migraine-specific medications. Significant associations with cerebrovascular diseases were observed in both males (ROR, 1.24 [95% CI, 1.19–1.30]; IC 0.31 [IC0.25, 0.24]) and females (1.73 [1.67–1.79]; 0.78 [0.72]), with most age groups showing significance, except for those 75 years and older. Among the 10 medication categories, 6 categories were associated with adverse cerebrovascular diseases: CGRP antagonists (ROR, 1.22 [95% CI, 1.12–1.33]; IC, 0.28 [IC0.25,0.14]), ergot alkaloids (3.66 [2.97–4.51]; 1.84 [1.49]), 5-HT₁ receptor agonists (3.33 [2.97–4.51]; 1.72 [1.59]), beta-blockers (2.03 [1.94–2.13]; 1.02 [0.94]), calcium channel blockers (1.46 [1.30–1.64]; 0.54 [0.34]), and clonidine (2.18 [2.04–2.33]; 1.11 [1.00]).

Conclusion

This study found that commonly used migraine medications are significantly associated with an increased risk of cerebrovascular diseases, highlighting the need for careful patient evaluation and selection.