Gene polymorphisms involved in triptans pharmacokinetics and pharmacodynamics in migraine therapy.

IMPORTANCE OF THE FIELD: Migraine is a debilitating and painful neurological disorder affecting millions of people worldwide and often worsened by chronification. Triptans represent a powerful pharmacological resource in migraine management; nevertheless, a significant portion of treated patients do not obtain consistent pain relief through triptans. Pharmacogenomics may offer a new way to rationalise triptans administration, based on characterisation of the individual genomic profile. AREAS COVERED IN THIS REVIEW: The review summarises the results of association studies between polymorphisms in genes involved in the kinetics and dynamics of triptans, and clinical response to them in migraineurs. WHAT THE READER WILL GAIN: A summary of data available at present from genetic studies in the field of triptan therapy in migraine, and a picture of the difficulties facing research into the pharmacogenomics of triptans. TAKE HOME MESSAGE: Pharmacogenomic studies of triptans suggest that some genetic determinants influence drug response, but the complexity of the field calls for application of a systematic approach to genetic association studies, allowing identification of a therapy response prediction panel with adequate predictive power.