Almotriptan and zolmitriptan in the acute treatment of migraine

Abstract

Objective: To compare almotriptan and zolmitriptan in the treatment of acute migraine. Methods: This multicentre, double-blind trial randomized adult migraineurs to almotriptan 12.5 mg (n ¼ 532) or zolmitriptan 2.5 mg (n ¼ 530) for the treatment of a single migraine attack. The primary end point was sustained pain free plus no adverse events (SNAE); other end points included pain relief and pain free at several time points, sustained pain free, headache recurrence, use of rescue medication, functional impairment, time lost because of migraine, treatment acceptability, and overall treatment satisfaction. Results: No significant difference was seen in SNAE (almotriptan 29.2% vs zolmitriptan 31.8%) or the other efficacy end points measured. The incidence of triptan-associated AEs and triptanassociated central nervous system AEs was significantly lower for patients receiving almotriptan compared to zolmitriptan. Conclusions: Almotriptan and zolmitriptan were associated with similar efficacy and overall tolerability in the treatment of acute migraine. Almotriptan was associated with a significantly lower rate of triptan-associated AEs.

Characteristics of Migraine Attacks and Responses to Almotriptan Treatment: A Comparison of Menstrually Related and Nonmenstrually Related Migraines

“…16 This is comparable to the 2-hour pain-relief rates of 65.4% and 70.2% and the 2-hour pain-free rates of 43.5% and 48.3% reported for almotriptan and zolmitriptan, respectively, in the primary analysis of all patients. 20 In agreement with these data, results of this current study have demonstrated that almotriptan is more effective than placebo in the acute treatment of migraine attacks, relief from migraine-associated symptoms, and providing a return to normal functioning in both MRM and nonMRM.…”

“…16 The large (N = 1061) multicenter, multinational, randomized, double-blind, parallel-group clinical trial, conducted at 118 centers in 9 European countries, evaluated the efficacy and tolerability of almotriptan 12.5 mg vs zolmitriptan 2.5 mg in the acute treatment of migraine. 20 A retrospective analysis of this trial included 902 women, 255 of whom treated a menstrual migraine attack (136 with almotriptan and 119 with zolmitriptan). 16 No significant difference between the 2 treatments was found and these findings also did not appear to be different from the primary analysis which included all patients and all migraines.…”

Treatment Recommendations Should Take Account of Individual Patient Variation Not Just Group Responses

“…Due to this and to differences in individual responses, including adverse effects, the effects to a therapy may vary. [19][20][21][22][23][24] Therefore it has been suggested by McQuay and coauthors that we need new trial designs in order to capture the reality of the range of response in clinical practice. 3 They have suggested that this design should have the following properties:…”

Catamenial migraine: epidemiology, pathogenesis, diagnosis, clinical features

“…Более того, авторы не выявили более значительного ограничения работоспособности при менструальной мигрени [2]. Мигрень одинаково хорошо ку-пируется с помощью немедикаментозного [11] и медикамен-тозного [14,30,[39][40][41] лечения в разные фазы менструально-го цикла. M. Diamond et al [28] выполнили ретроспективный анализ исследования AEGIS, проведенного в США в 2007 г. Авторы проанализировали все мигренозные атаки, зафикси-рованные у 190 пациенток, у которых за время исследования отмечалась хотя бы одна менструация.…”