Treatment with telmisartan, a long-acting angiotensin II receptor blocker, prevents migraine attacks in Japanese non-responders to lomerizine

Abstract

Lomerizine, calcium channel blocker, is the most used medication for migraine prophylaxis in Japan. The effectiveness of this drug is reported as 50-75%. Telmisartan is angiotensin II receptor blockers which plasma half-life is 24 h. We examined whether telmisartan has preventative benefits in lomerizine non-responsive migraineurs. Lomerizine non-responders received telmisartan (20 mg/day) for 3 months after the investigation period of 3 months. Blood pressure, frequency of headache days/month, headache severity, and doses of triptans and analgesics were analyzed by Wilcoxon signed rank test. Thirty-three migraineurs (25 women and 8 men) participated in this study. Seven patients had migraine with aura and 26 patients had migraine without aura. Mean age (SD) was 46.6 (10.3) years. Mean duration (SD) of migraine was 20.4 (12.5) years. Headache severity exhibited mild degree in 5 patients, moderate degree in 9 patients and severe degree in 19 patients. Mean frequency (SD) of headache days was 10.9 (8.5) days/month. Mean usage (SD) of triptans was 4.8 (5.1) tablets/month and that of analgesics was 15.2 (22.2) tablets/month. Five patients (15%) had hypertension. Telmisartan administration had benefits in 30 patients (90%). This medication significantly decreased frequency of headache days (P < 0.01) and headache severity (P < 0.01). Doses of triptans were reduced at one-third (P < 0.05) and those of analgesia at one-fifth after telmisartan treatment (P < 0.01). After telmisartan, mean (SD) of systolic blood pressure was significantly decreased (P < 0.05). The present study supported that telmisartan treatment had preventive effects in 90% of lomerizine non-responders. Telmisartan non-responders (10%) exhibited chronic migraine and long migraine duration.

Real world effectiveness and tolerability of candesartan in the treatment of migraine: a retrospective cohort study

“…In addition, patients treated with ARBs for reasons other than migraine showed a 31% lower incidence of headache during the treatment with these drugs 33 . The uniqueness of candesartan compared with other ARBs might be related to the selectivity, half-life, and tolerability 3 ; however, studies on other ARBs are even more scarce 34,35 .…”

Lomerizine 2HCl inhibits cell proliferation and induces protective autophagy in colorectal cancer via the PI3K/Akt/mTOR signaling pathway

“…In this study, based on a chemical library that consisted of FDA‐approved commercial drugs, we found that lomerizine 2HCl exhibited potent anticancer activity against CRC cells. It has been reported that lomerizine 2HCl can decrease the frequency of migraine headaches with an effectiveness of 50%–75% 22 . However, there have been no studies to investigate the anticancer effects of lomerizine 2HCl.…”

“…It has been reported that lomerizine 2HCl can decrease the frequency of migraine headaches with an effectiveness of 50%–75%. 22 However, there have been no studies to investigate the anticancer effects of lomerizine 2HCl. Thus, we provide the first line of evidence showing the suppressive effects of lomerizine 2HCl on cell growth, migration, and invasion.…”

News on the journal Neurological Sciences in 2017

“…Hypertension has been identified as one of the most important factors of chronic transformation of episodic migraine and increases the cerebrovascular and cardiovascular risk of migraine patients [76]. Telmisartan, a long-acting angiotensin II receptor blocker, has preventative benefits in non-responsive migraineurs [77]. OnabotulinumtoxinA, an effective treatment of chronic migraine, presents an increase of therapy efficacy and a progressive trend of "first-time response" [78].…”