A Double-Blind Comparison of Lysine Acetylsalicylate plus Metoclopramide vs Ergotamine plus Caffeine in Migraine

Titus, F; Escamilla, Carlos; Palmeira, Maria M. Gomes da Costa; Leira, Rogelio; Monteiro, José

doi:10.2165/00044011-200121020-00001

Cited by 7 publications

(19 citation statements)

References 5 publications

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“…Most of the studies displayed in FIGURE 1 also measured the number of patients who were pain free at 2 h (not study [33]). These results Boureau [28] Lipton [29] MacGregor [30] Sumatriptan Group [31] Chabriat [32] Tfelt-Hansen [33] Geraud [34] Titus [35] ASASUMAMIG group [38] Tfelt-Hansen [39] Lange [40] EMSASI Group [41] EMSASI Group adj [41] Diener [42] Studies with ASA 1000 mg tablets [28,29] showed responses and TGs of 22, 20, 11 and 14%, respectively, whereas the MacGregor study with 900 mg achieved lower results (14 and 9%, respectively) [30]. Results of studies with MCP are inconsistent with response rates between 5 and 32% [31,32,34,35].…”

Section: Discussionmentioning

confidence: 94%

“…Studies conducted with aspirin tablets in dosages of 1000 mg [28,29] and 900 mg [30] showed a very consistent response of approximately 50% and therapeutic gain (TG) of around 20%. Addition of the antiemetic MCP (10 mg) to a dosage of 900 mg ASA led to an improvement of the response [32,33,35]. However, this was to some extent inconsistent, since two studies were unable to confirm this improvement [31,34].…”

Section: Discussionmentioning

confidence: 99%

“…A total of 1620 mg LAS (= 900 mg ASA) plus 10 mg MCP compared with subcutaneous ergotamine (ERG) (2 mg) plus caffeine (CAF) (200 mg) [35] demonstrated similar positive results for LAS in the end point of headache relief from moderate-or-severe to mild-or-no pain after 2 h (77 vs 61%). Complete pain relief was obtained in a greater proportion of LAS plus MCP (32%) than in the ERG plus CAF group (23%).…”

Section: Parametermentioning

confidence: 97%

“…Tablet plus MCP Effervescent Boureau [28] Lipton [29] MacGregor [30] Sumatriptan group [31] Chabriat [32] Tfelt-Hansen [33] Geraud [34] Titus [35] ASASUMAMIG group [38] Tfelt-Hansen [39] Lange [40] EMSASI group [41] EMSASI group adj [41] Diener [42] % of patients 0 10 20 30 40 50 5 15 25 35 45 ASA Placebo TG …”

Section: Intravenousmentioning

confidence: 99%

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Aspirin in the treatment of acute migraine attacks

Diener

Lampl²,

Reimnitz

et al. 2006

Expert Review of Neurotherapeutics

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Acetylsalicylic acid (aspirin or ASA) has been used for many years as an analgesic, antipyretic and anti-inflammatory drug. In recent years, evidence for its effectiveness in migraine headache has been demonstrated in several clinical trials. The effervescent highly buffered preparation of aspirin was shown to be effective, safe and well tolerated compared with placebo or other treatment options. The effervescent aspirin preparation is at least as effective as the combination of aspirin plus metoclopramide, but has fewer side effects. This review summarizes and analyzes clinical data of aspirin in the treatment of acute migraine attacks with respect to the different galenic formulations.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Parametermentioning

confidence: 97%

Section: Intravenousmentioning

confidence: 99%

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Aspirin in the treatment of acute migraine attacks

Diener

Lampl²,

Reimnitz

et al. 2006

Expert Review of Neurotherapeutics

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“…Thirteen studies fulfilled the inclusion criteria for this review (Boureau 1994; Chabriat 1994; Diener 2004a; Diener 2004b; Geraud 2002; Henry 1995; Lange 2000; Le Jeunne 1998; Lipton 2005; MacGregor 2002; Tfelt-Hansen 1995; Thomson 1992; Titus 2001), with a total of 5261 treated migraine attacks (4222 participants) providing data; Boureau 1994; Diener 2004b; MacGregor 2002 together provided information on treatment of 1039 more migraine attacks than participants. Details of the included studies are provided in the Characteristics of included studies table.…”

Section: Resultsmentioning

confidence: 99%

Aspirin with or without an antiemetic for acute migraine headaches in adults

Kirthi

Derry

Moore

et al. 2010

Cochrane Database of Systematic Reviews

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Background Migraine is a common, disabling condition and a burden for the individual, health services and society. Many sufferers choose not to, or are unable to, seek professional help and rely on over-the-counter analgesics. Co-therapy with an antiemetic should help to reduce nausea and vomiting commonly associated with migraine headaches. Objectives To determine the efficacy and tolerability of aspirin, alone or in combination with an antiemetic, compared to placebo and other active interventions in the treatment of acute migraine headaches in adults. Search methods We searched Cochrane CENTRAL, MEDLINE, EMBASE and the Oxford Pain Relief Database for studies through 10 March 2010. Selection criteria We included randomised, double-blind, placebo- or active-controlled studies using aspirin to treat a discrete migraine headache episode, with at least 10 participants per treatment arm. Data collection and analysis Two review authors independently assessed trial quality and extracted data. Numbers of participants achieving each outcome were used to calculate relative risk and numbers needed to treat (NNT) or harm (NNH) compared to placebo or other active treatment. Main results Thirteen studies (4222 participants) compared aspirin 900 mg or 1000 mg, alone or in combination with metoclopramide 10 mg, with placebo or other active comparators, mainly sumatriptan 50 mg or 100 mg. For all efficacy outcomes, all active treatments were superior to placebo, with NNTs of 8.1, 4.9 and 6.6 for 2-hour pain-free, 2-hour headache relief, and 24-hour headache relief with aspirin alone versus placebo, and 8.8, 3.3 and 6.2 with aspirin plus metoclopramide versus placebo. Sumatriptan 50 mg did not differ from aspirin alone for 2-hour pain-free and headache relief, while sumatriptan 100 mg was better than the combination of aspirin plus metoclopramide for 2-hour pain-free, but not headache relief; there were no data for 24-hour headache relief. Associated symptoms of nausea, vomiting, photophobia and phonophobia were reduced with aspirin compared with placebo, with additional metoclopramide significantly reducing nausea (P < 0.00006) and vomiting (P = 0.002) compared with aspirin alone. Fewer participants needed rescue medication with aspirin than with placebo. Adverse events were mostly mild and transient, occurring slightly more often with aspirin than placebo. Authors’ conclusions Aspirin 1000 mg is an effective treatment for acute migraine headaches, similar to sumatriptan 50 mg or 100 mg. Addition of metoclopramide 10 mg improves relief of nausea and vomiting. Adverse events were mainly mild and transient, and were slightly more common with aspirin than placebo, but less common than with sumatriptan 100 mg.

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Aspirin with or without an antiemetic for acute migraine headaches in adults

Kirthi

Derry²,

Moore³

2013

Cochrane Database of Systematic Reviews

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BackgroundThis is an updated version of the original Cochrane review published in Issue 4, 2010 (Kirthi 2010. Migraine is a common, disabling condition and a burden for the individual, health services and society. Many sufferers choose not to, or are unable to, seek professional help and rely on over-the-counter analgesics. Co-therapy with an antiemetic should help to reduce nausea and vomiting commonly associated with migraine headaches. ObjectivesTo determine the efficacy and tolerability of aspirin, alone or in combination with an antiemetic, compared to placebo and other active interventions in the treatment of acute migraine headaches in adults. Search methodsWe searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, the Oxford Pain Relief Database, ClinicalTrials.gov, and reference lists for studies through 10 March 2010 for the original review and to 31 January 2013 for the update. Selection criteriaWe included randomised, double-blind, placebo-controlled or active-controlled studies, or both, using aspirin to treat a migraine headache episode, with at least 10 participants per treatment arm. Data collection and analysisTwo review authors independently assessed trial quality and extracted data. Numbers of participants achieving each outcome were used to calculate relative risk and numbers needed to treat (NNT) or harm (NNH) compared to placebo or other active treatment. Main resultsNo new studies were found for this update. Thirteen studies (4222 participants) compared aspirin 900 mg or 1000 mg, alone or in combination with metoclopramide 10 mg, with placebo or other active comparators, mainly sumatriptan 50 mg or 100 mg. For all efficacy outcomes, all active treatments were superior to placebo, with NNTs of 8.1, 4.9 and 6.6 for 2-hour pain-free, 2-hour headache relief, and 24-hour headache relief with aspirin alone versus placebo, and 8.8, 3.3 and 6.2 with aspirin plus metoclopramide versus placebo. Sumatriptan 50 mg did not differ from aspirin alone for 2-hour pain-free and headache relief, while sumatriptan 100 mg was better than the combination of aspirin plus metoclopramide for 2-hour pain-free, but not headache relief; there were no data for 24hour headache relief.

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A Double-Blind Comparison of Lysine Acetylsalicylate plus Metoclopramide vs Ergotamine plus Caffeine in Migraine

Cited by 7 publications

References 5 publications

Aspirin in the treatment of acute migraine attacks

Aspirin in the treatment of acute migraine attacks

Aspirin with or without an antiemetic for acute migraine headaches in adults

Aspirin with or without an antiemetic for acute migraine headaches in adults

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