Acute and Preventive Treatment of Migraine

Rizzoli, Paul

doi:10.1212/01.con.0000418641.45522.3b

Cited by 34 publications

(37 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[19][20][21] In the acute treatment of migraine, patients want medications that provide rapid relief, freedom from pain within 2 hours, relief from other symptoms such as photophobia, phonophobia, and nausea, no recurrence or longer times to recurrence, no need for rescue medication, efficacy that is maintained and does not decrease on subsequent attacks, absence of side effects, and oral administration. 13,21,22 In order to achieve these goals, ideal patient management should therefore include disease education, avoidance of potential trigger factors and an individually tailored, evidence-based treatment plan that is reassessed at frequent intervals.…”

Section: The Need For Rapid Pain Relief In Acute Migrainementioning

confidence: 99%

Novel Intranasal Delivery of Sumatriptan as a Route to Rapid and Sustained Relief in the Acute Treatment of Migraine

Friedman

2016

US Neurology

View full text Add to dashboard Cite

Migraine remains a common debilitating condition that exerts a high social and economic burden worldwide. Despite the widespread availability of various medications for migraine, many patients are dissatisfied with their treatment. Rapid and effective treatment at an early stage in an attack is vital in migraine to prevent central sensitization leading to attacks that are difficult to treat. Most migraineurs prefer oral medications but this is not always the most rapid or efficient route into the bloodstream. Intranasal administration of migraine treatment provides a rapid, convenient and reliable alternative to oral and other routes. AVP-825 is an intranasal medication delivery system approved by the US Food and Drug Administration in January 2016 as ONZETRA™ Xsail™ (sumatriptan nasal powder [Avanir Pharmaceuticals, Aliso Viejo, CA]) for the acute treatment of migraine with or without aura in adults. AVP-825 contains low dose sumatriptan powder and takes advantage of some unique aspects of the nasal anatomy to confer rapid pain relief in the acute treatment of migraine. In two Phase III trials, AVP-825 was well tolerated and showed significantly faster migraine pain relief and relief from other symptoms including photophobia, phonophobia, and nausea than placebo or oral sumatriptan. This benefit was achieved with substantially lower drug exposure than oral sumatriptan. Additional analyses of data from the Phase III trials show that significantly more patients with migraine receiving AVP-825 reported clinically meaningful relief, sustained relief, pain freedom, lower migraine-related disability and more consistent relief across multiple attacks than those receiving oral sumatriptan. The rapid and sustained action of AVP-825 and its convenience creates the potential for this unique treatment to reduce the burden of migraine in many patients.

show abstract

Section: The Need For Rapid Pain Relief In Acute Migrainementioning

confidence: 99%

Novel Intranasal Delivery of Sumatriptan as a Route to Rapid and Sustained Relief in the Acute Treatment of Migraine

Friedman

2016

US Neurology

View full text Add to dashboard Cite

show abstract

“…In the USA, ~17% of women and 6% of men have migraine, with peak prevalence occurring in both sexes between the ages of 25 and 55 years 3,4. Medications that produce agonist effects on serotonin 5-HT 1B and 5-HT 1D receptors, collectively known as “triptans”, are the most widely used prescription treatment for the acute management of migraine 5,6. Sumatriptan is the most commonly prescribed triptan, with substantial evidence supporting efficacy in treating migraine headache pain and associated symptoms 7.…”

Section: Introductionmentioning

confidence: 99%

Subcutaneous sumatriptan delivery devices: comparative ease of use and preference among migraineurs

Andre

Brand-Schieber

Ramírez

et al. 2017

PPA

View full text Add to dashboard Cite

BackgroundSeveral sumatriptan subcutaneous autoinjector devices for acute treatment of migraine patients are available, each device differs with respect to design and features. Determining device preference and ease of use is important because patients experiencing a migraine attack are often functionally impaired.ObjectiveThe objective of this human factors study was to compare migraine patients’ device use performance and preferences for three sumatriptan subcutaneous autoinjectors: a disposable two-step device (Zembrace® SymTouch®), a disposable three-step device (Sumavel® DosePro®), and a multistep reloadable device (Imitrex® STATdose®), using simulated injections.MethodsEach study subject performed two unaided simulated injections with each of three different drug delivery devices, which were presented in counterbalanced order. The participants were then asked to rate the three devices on various subjective measures. The primary end point was overall device preference using a visual analog scale.ResultsA total of 54 subjects participated and each subject performed two simulated injections with each of the three devices. Most subjects preferred the two-step device (88.9%) to the three-step (13.0%) and the reloadable (1.9%). The two-step device had higher mean overall preference ratings (F (2, 159)=56.6, P<0.01) and higher ratings for ease of use, intuitiveness, convenience, portability, and control. The two-step device had a first injection full-dose delivery success rate of 44.4%, higher than both the reloadable (24.1%) and the three-step (3.7%) devices. The number of errors with the two-step device (n=3) was ~90% lower than the three-step (n=49) and reloadable (n=44) devices.ConclusionIn this human factors study, 54 migraineurs used simulated injections to compare three sumatriptan subcutaneous delivery devices. Zembrace SymTouch, a two-step device, was most preferred compared with Sumavel DosePro and Imitrex STATdose. It also ranked highest for ease of use and various other measures. In this study, migraine patients preferred the autoinjector that they rated as simpler and more intuitive.

show abstract

“…Because of the short half-life of zolmitriptan in human, multiple dosages of oral administrations are required to resist the recurrence. Oral tablet may also worsen the situation when the migraine attached with significant nausea and vomiting (5). Hence, non-oral medicine administration is necessary to avoid these problems.…”

Section: Introductionmentioning

confidence: 99%

Drug in Adhesive Patch of Zolmitriptan: Formulation and In vitro /In vivo Correlation

Liu

Fang

2015

AAPS PharmSciTech

View full text Add to dashboard Cite

Abstract. The objective of the present study was to develop transdermal patch for zolmitriptan, determine its in vivo absorption using the rabbit skin. Solvent evaporation technique prepared zolmitriptan patch was settled in two-chamber diffusion cell combined with excised rabbit abdomen skin for permeation study. A sufficient cumulative penetration amount of zolmitriptan (258.5±26.9 μg/cm 2 in 24 h) was achieved by the formulation of 4% zolmitriptan, 10% Azone, and adhesive of DURO-TAK® 87-4098. Pharmacokinetic parameters were determined via i.v. and transdermal administrations using animal model of rabbit. The results revealed that the absolute bioavailability was about 63%. Zolmitriptan could be detected with drug level of 88±51 ng/mL after transdermal administration of 15 min. The in vivo absorption curve obtained by deconvolution approach using WinNonlin® program was correlated well with the in vitro permeation curve, the correlation coefficient R is 0.84, and the result indicated that in vitro skin permeation experiments were useful to predict the in vivo performance. In addition, little skin irritation was found in the irritation study. As a conclusion, the optimized zolmitriptan transdermal patches could effectively deliver adequate drug into systemic circulation in short time without producing any irritation phenomenon and worth to be developed.KEY WORDS: chemical enhancer; drug-in-adhesive patch; in vitro/in vivo correlation; pharmacokinetic; zolmitriptan.

show abstract

Acute and Preventive Treatment of Migraine

Cited by 34 publications

References 35 publications

Novel Intranasal Delivery of Sumatriptan as a Route to Rapid and Sustained Relief in the Acute Treatment of Migraine

Novel Intranasal Delivery of Sumatriptan as a Route to Rapid and Sustained Relief in the Acute Treatment of Migraine

Subcutaneous sumatriptan delivery devices: comparative ease of use and preference among migraineurs

Drug in Adhesive Patch of Zolmitriptan: Formulation and In vitro /In vivo Correlation

Contact Info

Product

Resources

About