DermatologistsBlog.com eInterview with: Julia Spoendlin MSc
Basel Pharmacoepidemiology Unit
Division of Clinical Pharmacy and Epidemiology,
Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
Hospital Pharmacy, University Hospital Basel, Basel, Switzerland
DermatologistsBlog.com: What are the main findings of the study?
This large primary care-based case-control study (including 53,927 rosacea patients) is based in a large and well-validated UK-based database (the General Practice Research Database – GPRD). Despite very scarce evidence, a notion of an association between rosacea and migraine sustained over decades. We assessed whether patients with prevalent migraine and / or previous triptan or ergot derivative exposure are at an increased risk of being diagnosed with rosacea. Our study is by far the largest study so far to address the association of the two diseases, and the first study to include the aspect of migraine medication in the study question (ie triptans and ergot derivatives). From a pathologic / mechanistic point of view triptans as well as ergot derivatives could potentially exert beneficial effects on rosacea via vasocontriction and anti-inflammatory properties.
Our findings do not support the hypothesis of an overall association between rosacea and migraine, but women, especially at post-menopausal ages, might be at a somewhat increased rosacea risk, with the highest OR in female migraineurs between 50 and 59 years of age (OR 1.36, 95% CI 1.21-1.53) . Triptans did not seem to affect the rosacea risk, but probably represent a proxy for migraine severity, with slightly increased risk estimates in triptan users when compared to the overall migraine population (OR 1.66, 95% CI 1.30-2.10 for female triptan users ≥60 years).
However, the actual effect size was relatively small also in post-menopausal females, and we are therefore reluctant to suggest a clinically relevant risk increase to develop rosacea also in this subgroup.
Thus, the main finding of our study is that we did not observe an overall association between prevalent migraine and incident rosacea. A potentially slightly increased risk in postmenopausal females with severe migraine will have to be followed up.
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