Early Treatment of a Migraine Attack while Pain is Still Mild Increases the Efficacy of Sumatriptan

Scholpp, Joachim; Schellenberg, R; Moeckesch, Beate; Banik, Norbert

doi:10.1111/j.1468-2982.2004.00802.x

Cited by 67 publications

(70 citation statements)

References 29 publications

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“…A retrospective subgroup analysis performed on protocol violators in a migraine trial suggested that sumatriptan is most effective in relieving migraine pain when treatment is initiated at an earlier, mild stage of migraine pain. 13 Recent clinical trials have demonstrated similar results with sumatriptan 14,15 and other triptans. 16,17 The present study was conducted in order to augment the evidence supporting the early treatment of migraine pain with sumatriptan.…”

supporting

confidence: 55%

“…Our results are also consistent with other studies that have examined the efficacy of triptans when used early in the treatment of migraine attacks. [14][15][16][17] Such studies have also shown relatively high pain-free response rates as compared to others in which the triptan was taken only after the headache had reached a moderate or severe intensity.…”

Section: The Canadian Journal Of Neurological Sciences 76mentioning

confidence: 99%

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Pain Free Efficacy of Sumatriptan in the Early Treatment of Migraine

Jelinski

Becker²,

Christie³

et al. 2006

Can J Neurol Sci.

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Migraine is a common neurological disorder that is characterized by episodic headaches associated with symptoms such as nausea, visual disturbances, photophobia, and phonophobia. In Canada, approximately 7% of adult males and 22% of adult females suffer from migraine. 1 Migraine symptoms result in a considerable burden with regard to health care utilization, health care costs, and work/productivity loss due to disability and decreased functional status. [2][3][4][5][6] Clinical trials have demonstrated that sumatriptan (Imitrex®, GlaxoSmithKline) is effective in relieving migraine pain. These studies have established the efficacy of sumatriptan among patients who treated their migraines at a point in which their headache pain was classified as moderate or severe. 7-11 However, ABSTRACT: Background: There is evidence that headache response rates may be higher if triptans are used early when a migraine attack is still mild, as compared to when it is treated after pain has reached moderate or severe intensity. Methods: In this randomized, double blind, placebo controlled, parallel group clinical trial, 361 patients took either placebo, sumatriptan 50 mg, or sumatriptan 100 mg in a single attack study. The primary outcome measure was pain-free status at two hours. Results: In the intention to treat group, two hour pain free rates were 16%, 40%, and 50% in the placebo group, sumatriptan 50 mg group, and the sumatriptan 100 mg group respectively (p<0.001, active treatment groups vs. placebo). Conclusions: Both sumatriptan 50 mg and 100 mg were significantly superior to placebo for the pain-free end point at two hours. The pain-free response rates in this trial where sumatriptan was taken while the headache was still mild were generally higher than in older clinical trials where headache was treated after reaching a moderate or severe intensity. RÉSUMÉ: Absence de douleur comme mesure de l'efficacité du sumatriptan pour le traitement précoce de la migraine. Contexte: Le taux de réponse serait plus élevé si les triptans sont utilisés tôt au cours d'une crise de migraine alors que les symptômes sont légers plutôt que quand la douleur est devenue modérée ou sévère. Méthodes: Il s'agit d'une étude de pharmacologie clinique randomisée, à double insu, avec placebo et groupes parallèles. 361 patients ont pris soit le placebo, le sumatriptan 50 mg ou le sumatriptan 100 mg au cours d'une seule crise migraineuse. Le critère d'évaluation primaire était l'absence de douleur 2 heures après la prise du médicament. Résultats: À l'analyse selon l'intention de traitement, le taux de patients sans douleur était de 16%, 40% et 50% pour le groupe placebo, le groupe sumatriptan 50 mg et le groupe sumatriptan 100 mg respectivement (groupes traitement actif versus placebo, p > 0,001). Conclusions: Le sumatriptan 50 mg et 100 mg étaient significativement supérieurs au placebo quant au critère d'évaluation primaire, soit l'absence de douleur 2 heures après la prise du médicament. Le taux de réponse, soit l'absence de douleur, dans cette étude ...

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supporting

confidence: 55%

Section: The Canadian Journal Of Neurological Sciences 76mentioning

confidence: 99%

Pain Free Efficacy of Sumatriptan in the Early Treatment of Migraine

Jelinski

Becker²,

Christie³

et al. 2006

Can J Neurol Sci.

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“…Pain-free efficacy of migraine pharmacotherapy appears to be enhanced, and the incidence of adverse events appears to be reduced by the practice of early intervention [Goadsby et al 2008;Silberstein et al 2008;Mathew et al 2007;Carpay et al 2004;Brandes et al 2005;Loder et al 2005;Mathew et al 2004;Scholpp et al 2004;Cady et al 2000]. These caveats notwithstanding, the results demonstrate the better performance of sumatriptan/naproxen sodium to sumatriptan monotherapy, naproxen sodium monotherapy and placebo with respect to the rigorous clinical endpoint of sustained pain-free/no adverse events and reinforce the usefulness of utilizing this new composite endpoint.…”

Section: Discussionmentioning

confidence: 69%

Fixed-dose sumatriptan/naproxen sodium compared with each monotherapy utilizing the novel composite endpoint of sustained pain-free/no adverse events

Landy¹,

White

Lener

et al. 2009

Ther Adv Neurol Disord

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A novel composite endpoint, sustained pain-free/no adverse events, was recently proposed as a more rigorous means of capturing in a single measure the attributes of migraine pharmacotherapy that patients consider most important: rapid and sustained pain-free response with no side-effects. Using pooled data from two replicate randomized, double-blind, parallel-group, placebo-controlled studies, this post hoc analysis compared the fixed-dose combination tablet sumatriptan/naproxen sodium (n ¼ 726) with sumatriptan monotherapy (n ¼ 723), naproxen sodium monotherapy (n ¼ 720), and placebo (n ¼ 742) with respect to sustained pain-free/no adverse events and closely related composite measures. Sustained painfree/no adverse events was defined as having both a sustained pain-free response from 2 through 24 hours post-dose with no use of rescue medication and having no adverse events within up to 5 days after dosing with study medication. The percentage of patients with sustained pain-free/no adverse events was 16% with sumatriptan/naproxen sodium compared with 11%, 9% and 7% for sumatriptan, naproxen sodium and placebo, respectively (p50.01 sumatriptan/naproxen sodium versus each other treatment). Sumatriptan/naproxen sodium was also significantly more effective than sumatriptan, naproxen sodium, and placebo for other composite endpoints including the percentages of patients with (1) sustained pain-free/no adverse events within 1 day; (2) sustained pain-free/no drug-related adverse events within up to 5 days; (3) sustained pain-free/no drug-related adverse events within 1 day; (4) sustained pain relief/no adverse events within up to 5 days; and (5) sustained pain relief/no adverse events within 1 day. The results demonstrate the superiority of sumatriptan/naproxen sodium to sumatriptan monotherapy, naproxen sodium monotherapy and placebo with respect to the rigorous and clinically relevant endpoint of sustained pain-free/no adverse events and reinforce the usefulness of utilizing this new composite endpoint.

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“…Важно отметить, что раннее купирование приступов М позволяет избежать не только рецидива ГБ, но и разви-тия центральной сенситизации, лежащей в основе хро-низации М [17,19].…”

Section: при приступах легкой и средней тяжести показаны простые аналunclassified

Effective Relief of Migraine Attacks: A Realistic Objective

Осипова¹

2017

Med. sov.

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Статья посвящена анализу эффективности лекарственных средств, применяемых для купирования приступов мигрени. Приводится клинический случай пациентки с мигренью.Ключевые слова: мигрень, купирование приступов, триптаны, суматриптан. V.V. OSIPOVA, MD, First Moscow State Medical University named after I.M. Sechenov, Scientific and Practical Neuropsychiatric Center of Moscow Healthcare Department EFFECTIVE RELIEF OF MIGRAINE ATTACKS: A REALISTIC OBJECTIVEThe article analyzes the effectiveness of drugs used for the relief of migraine attacks. A clinical case of a patient with migraine is described.

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Early Treatment of a Migraine Attack while Pain is Still Mild Increases the Efficacy of Sumatriptan

Cited by 67 publications

References 29 publications

Pain Free Efficacy of Sumatriptan in the Early Treatment of Migraine

Pain Free Efficacy of Sumatriptan in the Early Treatment of Migraine

Fixed-dose sumatriptan/naproxen sodium compared with each monotherapy utilizing the novel composite endpoint of sustained pain-free/no adverse events

Effective Relief of Migraine Attacks: A Realistic Objective

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