A nationwide study from Denmark presented at this year's European Congress on Obesity (ECO2026) in Istanbul, Turkey, shows that use of semaglutide (Wegovy) for weight management is associated with a 7% reduction in the use of triptan-class drugs for treatment in migraine one year after initiation. A sex-specific effect was observed, with women demonstrating an 8% reduction and men showing no significant change. The study is by Professor Anton Pottegård and Assistant Professor Noémie Roland, Department of Public Health, University of Southern Denmark, Odense, Denmark, and colleagues including from Novo Nordisk, the manufacturer of Wegovy, who sponsored the study.
Emerging evidence suggests that liraglutide, a glucagon-like peptide-1 receptor agonist (GLP-1RA), may demonstrate antimigraine effects. The authors decided to investigate in this new study whether initiation of semaglutide (Wegovy) for weight loss management, another GLP-1RA, impacted the use of triptans, a well-established class of drugs for acute migraine management.
In this nationwide study, the researchers identified all adults who initiated semaglutide for weight management in Denmark between December 1, 2022, and June 30, 2024, using the comprehensive Danish health registers. The date of the first dispensing of semaglutide was defined for each individual as the index date to allow for baseline (24 months before introduction) and follow-up (12 months after introduction) periods. The monthly use of triptans (expressed in defined daily doses [DDDs] per 10,000 individuals) before and after semaglutide introduction was compared using statistical modelling.
Additional analyses were conducted on the monthly number of new triptan users, and among prevalent users during the baseline period. Analyses were also performed by sex, age, semaglutide persistence (< or ≥ 4 dispensations within 12 months), and previous use of prophylactic antimigraine medication.
A total of 149,941 persons initiated semaglutide for weight management during the study period (69% women, median age 50 years). Among them, 4.6% received at least one dispensation of triptans in the year before semaglutide initiation, and 4.6% in the year after. Persistent semaglutide users (≥4 dispensations in the year after initiation) represented 87% of the cohort.
Before the initiation of semaglutide, monthly triptan DDD consumption showed an increasing trend of 7.8 DDDs/month/10,000 individuals. After semaglutide was introduced, this trend changed direction: over time, the use of these migraine medicines started to decrease (-14 DDDs/month/10,000). This change happened gradually rather than immediately after semaglutide introduction.
At 12 months post-intervention, a 7% relative reduction in triptan DDDs was observed compared to the expected rate based on pre-initiation trends. This decrease was attributable to a reduction in DDD use among prevalent users (−14% at 12 months) rather than a substantial decline in overall prescription number (−4%). In contrast, initiation of semaglutide had no impact on the monthly number of new triptan users, suggesting that semaglutide may reduce the need for acute migraine treatment in those with migraine history rather than preventing onset in previously unaffected individuals.
Sex-stratified analyses revealed a differential impact of semaglutide for weight management initiation on triptan use, with women (who made up 69% of the study population) showing an estimated −8% reduction in triptan consumption at 12 months post-intervention, whereas no significant change was observed among men. This may reflect sex-specific GLP-1RA responses, with greater semaglutide-associated weight loss typically observed in women. Additionally, the largest reductions occurred in individuals aged 18-35 years (-18%) and in previous users of prophylactic antimigraine medications (-13%).
Several factors may explain the observed decrease in migraine medication use. Weight loss and improvements in metabolic health may help reduce migraine frequency, partly through reduced inflammatory processes. In addition, GLP‑1RA treatments may have direct effects on the central nervous system that influence migraine pathways, independent of weight loss. Together, these findings may suggest a potential direct role of semaglutide in migraine improvement; however, the underlying biological mechanisms are not yet fully understood and warrant further investigation.
This nationwide study benefits from the use of comprehensive population‑wide data. However, the absence of clinical information, such as body weight or migraine characteristics, limits the ability to explore the pathways involved. In addition, initiation of semaglutide may reflect broader lifestyle and habit changes, which may have contributed to some of the study observations.
The authors conclude: "The study suggests that initiation of semaglutide is associated with a gradual reduction in triptan use during the first year after initiation among women."
