Migraine, triptans, and the risk of developing rosacea: a population-based study within the United Kingdom

Abstract

Background: Rosacea is a common skin disease, involving neurogenic inflammation and neurovascular dysregulation. Migraine has been associated with vascular changes and sterile inflammation. The 2 diseases have been associated over decades, but evidence is scarce. Triptans have vasoconstricting and antiinflammatory properties, but a potential impact of this drug class on rosacea remains uninvestigated.

Objective: We sought to analyze the association between migraine or triptan exposure and the risk of developing rosacea within the United Kingdom.

Methods: We conducted a case-control study using the United Kingdom-based General Practice Research Database. We identified patients with incident rosacea between 1995 and 2009 (cases), and matched 1 rosacea-free control subject to each case. We compared the prevalence of diagnosed migraine and exposure to triptans before the first-time rosacea diagnosis between cases and controls using multivariate conditional logistic regression.

Results: Among 53,927 cases and 53,927 controls, we observed a small overall association between rosacea and migraine in women (adjusted odds ratio 1.22, 95% confidence interval 1.16-1.29), but not in men. This effect was somewhat more distinct in female migraineurs aged 50 to 59 years (odds ratio 1.36, 95% confidence interval 1.21-1.53). Female triptan users also revealed slightly increasing risk estimates with increasing age, with the highest odds ratio of 1.66 (95% confidence interval 1.30-2.10) in women aged 60 years or older.

Limitations: This is a retrospective case-control study, for which a certain degree of bias and confounding cannot be ruled out.

Conclusions: We observed a slightly increased risk for female migraineurs to develop rosacea, particularly in women with severe migraine aged 50 years or older.

Keywords: CI; GP; GPRD; General Practice Research Database; HRT; MHRA; Medicines and Healthcare Products Regulatory Agency; OR; confidence interval; general practitioner; hormone replacement therapy; migraine; odds ratio; population-based; rosacea; triptans.