Efficacy of frovatriptan versus other triptans in the acute treatment of menstrual migraine: pooled analysis of three double-blind, randomized, crossover, multicenter studies

Allais, Gianni; Tullo, V.; Omboni, Stefano; Benedetto, Chiara; Sances, Grazia; Zava, Dario; Ferrari, Michel D.; Bussone, Gennaro

doi:10.1007/s10072-012-1044-7

Cited by 19 publications

(30 citation statements)

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“…An additional interesting finding of our retrospective analysis is that immediate and delayed efficacy of frovatriptan in the subgroup of OCMM is superimposable to that previously observed in the whole subgroup of women with menstrual migraine [6]. …”

Section: Discussionsupporting

confidence: 55%

“…As shown in numerous randomized trials, frovatriptan represents a well known and effective option for acute [4–6, 11] or prophylactic treatment [15–17] of menstrual migraine. The present study, based on a pooled analysis of three double-blind, randomized, direct comparative, cross-over studies [12–14], demonstrates that frovatriptan is clinically effective also for the acute treatment of OCMM, a particular menstrual migraine subtype.…”

Section: Discussionmentioning

confidence: 99%

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Frovatriptan vs. other triptans for the acute treatment of oral contraceptive-induced menstrual migraine: pooled analysis of three double-blind, randomized, crossover, multicenter studies

et al. 2013

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Oral contraceptive-induced menstrual migraine (OCMM) is a particularly severe form of migraine triggered by the cyclic hormone withdrawal. To review the efficacy of frovatriptan vs. other triptans, in the acute treatment of OCMM through a pooled analysis of three individual randomized Italian studies. With or without aura migraineurs were randomized to frovatriptan 2.5 mg or rizatriptan 10 mg (study 1), frovatriptan 2.5 mg or zolmitriptan 2.5 mg (study 2), frovatriptan 2.5 mg or almotriptan 12.5 mg (study 3). All studies had a multicenter, randomized, double-blind, crossover design. After treating 1–3 episodes of migraine in 3 months with the first treatment, patients switched to the other treatment for the next 3 months. In this analysis, the subset of 35 of the 280 women of the intention-to-treat population taking combined oral contraceptives and experiencing a migraine attack during the withdrawal phase, were analyzed. The proportion of pain free and pain relief at 2 h were 25 and 51 % with frovatriptan and 28 and 48 % with comparators (p = NS). At 24 h, 71 and 83 % of frovatriptan-treated patients and 60 and 76 % of comparator-treated patients were pain free (p < 0.05 between treatments) and had pain relief (p = NS), respectively. Relapse at 24 and 48 h was significantly (p < 0.05) lower with frovatriptan (17 and 21 %) than with the comparators (27 and 31 %). Our results suggest that, due to its sustained antimigraine effect, frovatriptan may be particularly suitable for the management of OCMM than other triptans.

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Section: Discussionsupporting

confidence: 55%

Section: Discussionmentioning

confidence: 99%

Frovatriptan vs. other triptans for the acute treatment of oral contraceptive-induced menstrual migraine: pooled analysis of three double-blind, randomized, crossover, multicenter studies

et al. 2013

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“…What is particularly significant is the number of women who were already reporting a pain-free state at 4 h (64 %) and even more remarkably at 24 h (76 %). Comparative studies of other triptans were used for treating, an acute attack of MRM showed that frovatriptan is highly effective when used alone it produced a pain-free state in 52 % of the patients at 4 h, and in 66 % of the patients at 24 h [15]. Therefore, if the above result is compared with the percentages of frovatriptan’s effectiveness obtained in the present trial, it becomes quite clear that added benefit can be derived from combining dexketoprofen with frovatriptan rather than using frovatriptan alone.…”

Section: Discussionmentioning

confidence: 99%

Frovatriptan plus dexketoprofen in the treatment of menstrually related migraine: an open study

et al. 2013

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At least 50 % of female migraineurs experience migraine associated with the perimenstrual period, even though they may also suffer from attacks at other times of the cycle (menstrually related migraine, MRM). MRM attacks tend to be longer and more intense than those arising in other phases of the menstrual cycle, and are often aggravated by more pronounced vegetative phenomena. In this open preliminary trial, we tested the efficacy of associating frovatriptan and dexketoprofen for the treatment of an acute attack of MRM, diagnosed according to the criteria of the International Headache Society, in 24 patients between 19 and 45 years of age (mean 31.33 ± 7.33). Twenty-one of them completed the study. Pain relief was achieved by 76 % of patients at 2 h and by 86 % at 4 h. A pain-free state was achieved by 48 % at 2 h and by 62 % at 4 h from taking the product. A pain-free state at 24 h was present in 76 % of MRM sufferers, 33 % of whom showed a sustained pain-free state at 24 h. A rescue medication was needed by eight patients. While decidedly encouraging, the data of this study obviously need confirmation with double blind studies involving a greater number of patients.

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“…In the pooled analysis of the three direct comparative studies of frovatriptan versus other triptans, a total of 18 drug-related adverse events were recorded in 401 menstrually related attacks treated [Allais et al 2012]. No statistically significant differences were observed in the rate of attacks associated with drug-related adverse events between frovatriptan (5%) and the comparators (4%).…”

Section: Safety Of Frovatriptan In MMmentioning

confidence: 99%

“…Previous medications were rated at baseline as good or very good for effectiveness by only 20% of menstrual migraineurs and 19% of nonmenstrual migraineurs, while the Table 4. Demographic and clinical characteristics and main efficacy parameters for the whole population of three randomized controlled studies comparing frovatriptan with rizatriptan, zolmitriptan, or almotriptan, and for the subgroup of women with menstrually related migraine (Allais et al [2012]; Cortelli et al [2011] …”

Section: Efficacy Of Frovatriptan In Mm: Evidence From Open-label Stumentioning

confidence: 99%

A review of the use of frovatriptan in the treatment of menstrually related migraine

Allais

Benedetto

2012

Ther Adv Neurol Disord

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Current therapeutic approach to MMThe therapeutic approach to patients with MRM is based on treatment of the symptoms of attack, or with prophylactic strategies [Silberstein et al. 2012;Steiner et al. 2007].A review of the use of frovatriptan in the treatment of menstrually related migraine Gianni Allais and Chiara Benedetto Abstract: Menstrual migraine (MM) is a highly prevalent condition associated with considerable disability. Migraine attacks occur exclusively around the menstrual period in approximately 10% of women with migraine, that is, pure menstrual migraine, while at least 50% of them also experience migraine at other times of the month, that is, menstrually related migraine (MRM). The therapeutic approach to patients with MRM is based on treatment of the attack, or prophylactic strategies. Triptans are recommended as first-line treatments for moderate to severe migraine attacks, including MM. Frovatriptan is one of the newest triptans. Its high affinity for 5-HT 1B/1D receptors and long half-life contribute to its distinctive clinical effect, characterized by a more sustained and prolonged effect than other triptans. Indeed, frovatriptan proved to be effective in treating the acute attack, but was particularly effective in the short-term preventive therapy of MM. In addition, frovatriptan is one of the safest triptans, with the lowest risk of treatment-emergent adverse events. Following extensive evidence from randomized pharmacological trials, frovatriptan has now gained a grade A recommendation from the guidelines for short-term prophylaxis of MM. Recent post-hoc analyses of direct comparative trials also suggest that frovatriptan might have an important role in the acute treatment of MRM. In these studies, frovatriptan showed pain relief and pain-free rates similar to those of zolmitriptan, rizatriptan, and almotriptan, but with significantly lower recurrence rates. More well-designed, randomized, prospective studies, specifically enrolling women with MM, will be needed in the near future to confirm the efficacy of frovatriptan in this migraine subtype.

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Efficacy of frovatriptan versus other triptans in the acute treatment of menstrual migraine: pooled analysis of three double-blind, randomized, crossover, multicenter studies

Cited by 19 publications

References 19 publications

Frovatriptan vs. other triptans for the acute treatment of oral contraceptive-induced menstrual migraine: pooled analysis of three double-blind, randomized, crossover, multicenter studies

Frovatriptan vs. other triptans for the acute treatment of oral contraceptive-induced menstrual migraine: pooled analysis of three double-blind, randomized, crossover, multicenter studies

Frovatriptan plus dexketoprofen in the treatment of menstrually related migraine: an open study

A review of the use of frovatriptan in the treatment of menstrually related migraine

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