Evolution of use and overuse of triptans in Austria – What has changed in the last 15 years?

Abstract Background Triptans are highly effective acute treatments for migraine attacks, yet population-level data suggest persistent underuse. Updated real-world data on triptan use and overuse in Austria are lacking. Methods This nationwide, retrospective claims-based study analysed triptan use and overuse in Austria in 2023. Adults (≥ 18 years) with at least one dispensed triptan were identified. Triptan overuse was defined as the dispensing of ≥ 30 defined daily doses (DDDs) in at least one quarter, consistent with the International Classification of Headache Disorders, 3rd edition (ICHD-3) criteria. Data on demographics, preventive migraine therapies, antidepressant use, sick leave, and hospital admissions were assessed and compared with data from 2007 using identical methodology. Results Among 7.75 million insured adults, 63,729 individuals (0.82%) fulfilled the inclusion criteria and used triptans, representing a 46% increase since 2007. However, this corresponds to an estimated number of approximately 8% of individuals with migraine. Triptan overuse more than doubled compared with 2007 (12.5% vs. 5.9%) and was associated with older age, with the largest proportion of overusers being 51–65 years old. Overusers showed substantially higher use of preventive therapies, including anti-calcitonin-gene-related-peptide (CGRP) antibodies (21.8% vs. 9.7%), and antidepressants (24.8% vs. 19.9%) (all p