Some triptans are more efficacious for acute migraines than newer, more expensive drugs including gepants, a review of 137 randomised controlled trials suggests.

Writing in The BMJ last week, the University of Oxford researchers say the top-performing triptans should be considered the treatment of choice for migraine episodes.

“Our findings showed that some triptans — namely, eletriptan, rizatriptan, sumatriptan, and zolmitriptan — had the most favourable overall profiles in terms of efficacy and tolerability,” they wrote.

“These four triptans were more efficacious than the most recently marketed drugs lasmiditan, rimegepant, and ubrogepant, which, based on our results, showed efficacy comparable to that of paracetamol and most NSAIDs.”