The effectiveness of combined oral lysine acetylsalicylate and metoclopramide compared with oral sumatriptan for migraine

Tfelt‐Hansen, Peer; Henry, Patrick; Mulder, L. J. M. M.; Scheldewaert, Rudy; Schoenen, Jean; Carrault, Guy

doi:10.1016/s0140-6736(95)91554-0

Cited by 207 publications

(149 citation statements)

References 9 publications

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“…The rate of success obtained with CM was similar to what has been previously published with the association aspirin plus metoclopramide [9, 10, 11, 13]. In two double-blind, placebo-controlled studies, the efficacy rates of the association aspirin (900 mg) plus metoclopramide (10 mg) at relieving and curing headache were 58 and 18% [9], and 54 and 14% [10].…”

Section: Discussionsupporting

confidence: 80%

“…In two double-blind, placebo-controlled studies, the efficacy rates of the association aspirin (900 mg) plus metoclopramide (10 mg) at relieving and curing headache were 58 and 18% [9], and 54 and 14% [10]. In one double-blind study of combined oral lysine acetylsalicylate and metoclopramide versus oral sumatriptan, the success rate was 57% of which 22% of patients were cured [11]. Only in one study of CM versus oral dihydroergotamine were the efficacy rates higher than in our study; 64% for success, of which 41% of the patients were cured [13].…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, metoclopramide is effective in relieving nausea and vomiting frequently associated with migraine. A combination of 900 mg aspirin and 10 mg metoclopramide in the treatment of migraine attacks has been shown to be more effective than placebo [9, 10]and as effective as oral sumatriptan [11]. Calcium carbasalate is a soluble complex of aspirin that has been shown to be less harmful to the stomach than plain aspirin [12].…”

Section: Introductionmentioning

confidence: 99%

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Comparative Efficacy and Safety of Calcium Carbasalate plus Metoclopramide versus Ergotamine Tartrate plus Caffeine in the Treatment of Acute Migraine Attacks

et al. 1999

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This randomized, double-blind, double-dummy, multicenter, parallel-group study aimed at comparing the efficacy and safety of calcium carbasalate (equivalent to 900 mg aspirin) plus metoclopramide 10 mg (CM) with ergotamine tartrate 1 mg plus caffeine 100 mg (EC) administered in the treatment of 2 acute migraine attacks. A total of 296 patients fulfilling the International Headache Society diagnostic criteria for migraine were enrolled. In total, one or two migraine attacks were treated in 268 and 235 patients, respectively. The primary endpoint for the first treated attack was headache relief, with intensity decreasing from moderate or severe to mild or absent 2 h after drug intake. Usual secondary efficacy endpoints were assessed. A superiority of CM over EC was observed for both treated attacks for the main endpoint: success in 54 versus 36%, p = 0.003 for the first attack and 60 versus 44%, p = 0.02 for the second attack. CM was also significantly superior to EC during the first attack for complete headache relief (20 vs. 8%, p = 0.006), nausea (42 vs. 63%, p = 0.007) and willingness to take the drug again (90 vs. 80%, p = 0.043). The global efficacy evaluation, rated by the investigators, was significantly more favorable to CM for both attacks (p = 0.001 for the first attack and p = 0.02 for the second). The patients’ evaluation was significant for the first attack (p = 0.002). The global incidence of adverse events was 45% higher with EC, though not significant (32 vs. 22%, p = 0.075). They were most often unspecific and mild to moderate in intensity. Gastrointestinal side effects were significantly less frequent with CM than EC (7 vs. 21%, p = 0.001). Thus, CM is more effective and has a better gastrointestinal safety than EC in the acute treatment of migraine attacks.

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Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comparative Efficacy and Safety of Calcium Carbasalate plus Metoclopramide versus Ergotamine Tartrate plus Caffeine in the Treatment of Acute Migraine Attacks

et al. 1999

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“…Patients' most commonly given reasons for preferring triptans were effective relief, speed of relief, restored ability to function and fewer side effects [16,18,19,22]. These are significant results, as some controlled clinical trials have shown that sumatriptan was not superior to rapid-release tolfenamic acid [43], paracetamol/domperidone [44], aspirin/metoclopramide [45,46], isometheptene/paracetamol/dichlorphenazone [47] and paracetamol/aspirin/caffeine [48]. In contrast, a controlled clinical trial showed that oral sumatriptan 100 mg was significantly superior to oral ergotamine plus caffeine [49].…”

Section: Discussionmentioning

confidence: 99%

Patients’ preference for triptans and other medications as a tool for assessing the efficacy of acute treatments for migraine

Dowson

Tepper

Dahlöf³

2005

J Headache Pain

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Oral triptans are effective and well tolerated acute treatments for migraine, but clinical differences between them are small and difficult to measure in conventional clinical trials. Patient preference assesses a global measure of efficacy and tolerability, and may be a more sensitive means of distinguishing between these drugs. In a series of studies, patients consistently expressed a clear preference for triptans over their usual non–triptan acute medications, e.g., analgesics and ergotamine. Direct comparator studies of patient preference with oral triptans showed that patients could distinguish between different triptans, and between different formulations of the same triptan. Patients could even distinguish between the three oral doses of sumatriptan. The most frequently provided reasons for preference were speed of response and overall effectiveness. Patient preference is a sensitive clinical trial endpoint and physicians should consider using it when reviewing the efficacy of acute migraine medications.

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“…The combination of lysine acetylsalicylic acid and metoclopamide (56%) was as effective as sumatriptan 100 mg (53% relief) and both were superior to placebo (24%) in one RCT [34]. Trimebutine is also a prokinetic drug and in one RCT the combination of trimebutine plus rizatriptan (73% pain-free) was superior to rizatriptan alone (42% pain-free) [35,36].…”

Section: Use Of Prokinetic Drugs and Neurolepticsmentioning

confidence: 99%

Acute pharmacotherapy of migraine, tension-type headache, and cluster headache

Tfelt‐Hansen

2007

J Headache Pain

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In most migraine patients acute therapy is needed. Migraine can be treated either with specific drugs, the triptans and ergot alkaloids, or with NSAIDs. Triptans are a major step foreward in migraine therapy. The therapeutic gain for headache relief is 50% for subcutaneous sumatriptan whereas it is 30-40% for most oral triptans. After oral triptans sustained pain free is only 30%. There is thus still ample room for improvement of acute therapy in migraine. For tension-type headache there is no specific therapy and it is treated with NSAIDs. Only 17-32% become pain free after these drugs. For attacks of cluster headache oxygen and subcutaneous sumatriptan can be used. Intranasal triptans can be an alternative.

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The effectiveness of combined oral lysine acetylsalicylate and metoclopramide compared with oral sumatriptan for migraine

Cited by 207 publications

References 9 publications

Comparative Efficacy and Safety of Calcium Carbasalate plus Metoclopramide versus Ergotamine Tartrate plus Caffeine in the Treatment of Acute Migraine Attacks

Comparative Efficacy and Safety of Calcium Carbasalate plus Metoclopramide versus Ergotamine Tartrate plus Caffeine in the Treatment of Acute Migraine Attacks

Patients’ preference for triptans and other medications as a tool for assessing the efficacy of acute treatments for migraine

Acute pharmacotherapy of migraine, tension-type headache, and cluster headache

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