Rofecoxib in the Prevention of Perimenstrual Migraine: An Open‐Label Pilot Trial

Seggern, Randal L. Von; Mannix, Lisa K.; Adelman, James U.

doi:10.1111/j.1526-4610.2004.04033.x

Cited by 21 publications

(10 citation statements)

References 25 publications

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“…93 Although an open-label study suggested that perimenstrual rofecoxib significantly reduced the frequency of perimenstrual migraine, there is no evidence that the new cyclo-oxygenase-2 (COX-2) inhibitors (rofecoxib, celecoxib, valdecoxib) are more effective than traditional NSAIDs. 94 Figure 3 Algorithm for the management of menstrual attacks of migraine. CHC, combined hormonal contraceptives; GnRH, gonadotrophinreleasing hormone; HFI, hormone-free interval; HRT, hormone replacement therapy; IUS, intrauterine system; NSAIDs, non-steroidal anti-inflammatory drugs costly but may provide a relative safety advantage for patients who need to use these agents for long periods of time and who are especially prone to gastrointestinal complications.…”

Section: Non-steroidal Anti-inflammatory Drugsmentioning

confidence: 99%

Menstrual migraine: a clinical review

MacGregor¹

2007

j fam plann reprod health care

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OverviewMigraine attacks are often associated with menstruation in many, but not all, women with migraine. To date, no hormonal abnormalities have been identified in these women and it appears that normal hormonal fluctuations are associated with an abnormal central nervous system response. Diagnosis of migraine and confirmation of menstrual association is clinical, based on headache history and review of diary cards. Tests of hormone levels are rarely useful. Standard drugs to treat the acute symptoms suffice for the majority of women with monthly attacks. If acute therapy alone is inadequate, pre-emptive treatment of the expected menstrual headache with perimenstrual estradiol, triptans or non-steroidal anti-inflammatory drugs (NSAIDs) may be effective. Suppression of the menstrual cycle with anovulatory contraceptive agents is an additional option, particularly for women who also require contraception. A variety of other treatments have been studied, but the quality of evidence for their use is generally poor. Search strategyData for this review were identified by a MEDLINE search using the following search terms: estrogen, estradiol, menstruation, menstrual cycle, menstrual migraine, menstrually related migraine, menstrually associated migraine, migraine and progesterone. The resultant search identified 554 publications. The Cochrane search strategy for identifying reports of randomised controlled trials was run on this database. 1 The search strategy identified 103 publications, which were scrutinised for relevancy to this review.In addition, references from the author's own files, a hand search of the journals Cephalalgia and Headache, and peer-reviewed presentations at international congresses were considered. How common is migraine?The two most frequently encountered types of migraine differ only in their presence or absence of 'aura' (Box 1). 2 About 70-80% of migraineurs experience attacks of migraine without aura (formerly known as common or simple migraine), 10% have migraine with aura (formerly known as classical or focal migraine) and 15-20% have both types of attacks. Less than 1% of attacks are of aura alone, with no ensuing headache.Migraine is equally common in both sexes before puberty, with increased female prevalence following menarche. 3 At puberty, the incidence of migraine without aura rises in females, 4 with 10% to 20% of women reporting migraine with menarche. 5 This sex difference becomes greater with increasing age, peaking during the early 40s and declining thereafter. The lifetime prevalence of migraine is around 25% in women compared to only 8% in men. [6][7][8]

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Section: Non-steroidal Anti-inflammatory Drugsmentioning

confidence: 99%

Menstrual migraine: a clinical review

MacGregor¹

2007

j fam plann reprod health care

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“…In another study, patients with MM (PMW: -2/+3) received rofecoxib 25 mg or 50 mg once daily for 10 days, starting 5 days before the onset of menstruation in two consecutive cycles [56]. Mean migraine frequency decreased from 5.6 to 2.6 attacks per cycle (p = 0.005).…”

Section: Nonsteroidal Anti-inflammatory Drugsmentioning

confidence: 97%

Menstrual migraine: clinical and therapeutical aspects

Allais¹,

Gabellari²,

Lorenzo³

et al. 2007

Expert Review of Neurotherapeutics

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Estrogens fluctuations, particularly their premenstrual fall, are currently regarded as the main triggers of menstrual migraine (MM). MM presents in two clinical forms: pure MM, where attacks are confined to the perimenstrual period (PMP), and menstrually related migraine, where attacks always occur during, but are not confined to, the PMP. MM episodes are usually longer, more intense, more disabling and more refractory than nonmenstrual attacks. Acute management of MM should initially be abortive and primarily sought with triptans. If this fails, short-term perimenstrual prophylaxis with NSAIDs, coxibs, triptans or ergotamine derivatives can be considered. Hormone manipulations, mainly application of percutaneous estradiol gel in PMP or administration of oral contraceptives in extended cycles, constitute an alternative approach for nonresponders.

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“…Use of naproxen sodium, which was evaluated in a double-blind, placebo-controlled study of women with MM, was associated with a significant reduction in headache intensity, the number of days of headache, and total analgesic consumption, compared with placebo [41,Class I]. In an open-label trial of 14 women randomized to treatment with rofecoxib 25 or 50 mg daily for 10 days, beginning 5 days before expected onset of menses, for two cycles, the mean migraine frequency decreased from 5.6 to 2.6 migraines per menstrual cycle [42,Class II]. Some patients may respond better to one NSAID than to another, which suggests that switching NSAIDs may be beneficial to patients who do not respond to an initial trial.…”

Section: Eletriptanmentioning

confidence: 98%

Menstrual migraine

Mannix¹,

Calhoun²

2004

Curr Treat Options Neurol

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The initial treatment of menstrual migraine (MM) should be the same as that of migraine that occurs at any other time during the month and should include lifestyle modifications and the use of appropriate acute therapies aimed at decreasing attack symptoms, duration, and disability. If results of acute therapy are incomplete or unsatisfactory, then preventive strategies may be required. Comorbidities may, however, influence choice of preventive therapy or accelerate initiation of preventive therapy. Comorbid dysmenorrhea, menometrorrhagia, and endometriosis argue for early use of hormonal therapies. Hormonal strategies may be appropriate because the premenstrual decline in estradiol concentration predictably precipitates MM, and targeting and preventing this decline can decrease headache occurrence. Continuous combined hormonal contraceptives can reduce hormone fluctuations and, for some MM sufferers, can deliver more than contraceptive benefits. Nonsteroidal anti-inflammatory drugs are appropriate for treatment of co-occurring dysmenorrhea or when hormonal strategies are contraindicated; their efficacy may be caused partly by the role of prostaglandins in MM and dysmenorrhea. As with the use of hormonal therapy, use of nonsteroidal anti-inflammatory drugs allows for treatment of breakthrough headache with triptans. Results of clinical trials suggest that daily use of triptans in the menstrual window may bring about as much as 50% reduction in headache frequency, but such use still requires acute treatment of breakthrough headache and adherence to daily triptan limits. Use of this strategy requires that headache occurrence be highly predictable.

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Rofecoxib in the Prevention of Perimenstrual Migraine: An Open‐Label Pilot Trial

Abstract: Rofecoxib at a perimenstrual daily dose of 25 or 50 mg demonstrated a significant reduction in frequency of perimenstrual migraine. A double-blind, placebo-controlled trial of rofecoxib in the prevention of perimenstrual migraine is warranted.

Cited by 21 publications

References 25 publications

Menstrual migraine: a clinical review

Menstrual migraine: a clinical review

Menstrual migraine: clinical and therapeutical aspects

Menstrual migraine

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