Treatment response and tolerability of frovatriptan in patients reporting short- or long-duration migraines at baseline

Kelman, Leslie; Harper, Samira Q.; Hu, Xiaojun; Campbell, John C.

doi:10.1185/03007995.2010.503488

Cited by 8 publications

(7 citation statements)

References 31 publications

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“…This reinforces evidence from previous placebo-controlled or head-to-head trials in non menstrually related migraine, namely that frovatriptan, used for immediate or repeated sustained use, is one of the best tolerated triptans Cady et al 2009;Géraud et al 2002;Kelman et al 2010;Poolsup et al 2005;Wallasch, 2010].…”

Section: Resultssupporting

confidence: 85%

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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Section: Resultssupporting

confidence: 85%

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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“…Our study suggests that frovatriptan is an effective agent when used as intermittent prophylactic therapy, as previously shown in studies including women with menstrual migraine17,19–21 and in patients with long-duration or recurrent migraine attacks 22…”

Section: Discussionsupporting

confidence: 86%

Symptomatic or prophylactic treatment of weekend migraine: an open-label, nonrandomized, comparison study of frovatriptan versus naproxen sodium versus no therapy

Guidotti¹,

Barrilà²,

Leva³

et al. 2013

NDT

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BackgroundMigraine often occurs during weekends. The efficacy of frovatriptan, naproxen sodium, or no therapy for the acute or prophylactic treatment of weekend migraineurs was tested in an open-label, nonrandomized pilot study.MethodsTwenty-eight subjects (mean age 36 ± 12 years, including 18 females) suffering from migraine without aura were followed up for six consecutive weekends. No treatment was administered during the first two weekends. On the third and fourth weekends, patients were given frovatriptan 2.5 mg and on the fifth and sixth weekends naproxen sodium 500 mg. Treatment was taken on Saturday and Sunday morning, regardless of the occurrence of migraine. Efficacy was evaluated through a diary, where patients reported the severity of migraine on a scale from 0 (no migraine) to 10 (severe migraine) and use of rescue medication.ResultsThe migraine severity score was significantly lower with frovatriptan (4.8 [95% confidence interval (CI) 3.8–5.9]) than with naproxen sodium (5.7 [CI 5.1–6.4], P< 0.05 versus frovatriptan) or no therapy (6.6 [6.2–7.0], P< 0.01 versus frovatriptan). The difference in favor of frovatriptan was more striking in patients not taking rescue medication (frovatriptan, 1.9 [1.5–2.3]) versus naproxen sodium 3.6 [3.0–4.2], P< 0.001) and versus no therapy (5.1 [4.4–5.8], P< 0.001) and on the second day of treatment. The rate of use of rescue medication was significantly (P< 0.05) lower on frovatriptan (12.5%) than on naproxen sodium (31.3%) or no therapy (56.3%).ConclusionThis pilot study provides the first evidence of the efficacy of a second-generation triptan as symptomatic or prophylactic treatment for weekend migraine.

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“…This is in line with results of open label naturalistic studies and meta-analyses of placebo-controlled efficacy studies, which suggest that in a real world setting frovatriptan is associated with a lower rate of migraine recurrence than with other triptans [25]. Post-marketing surveys also indicate that the long duration of action of frovatriptan appears to confer other benefits such as greater patient satisfaction, with over 80–90% of patients and physicians rating frovatriptan therapy as very good or good, both in terms of efficacy and tolerability [10–12, 25]. …”

Section: Discussionmentioning

confidence: 99%

“…Pharmacokinetic features of frovatriptan may make it suitable for patients who need prophylaxis such as in menstrual-related migraine and in patients with long-duration or recurrent migraine attacks [24, 26, 27]. In these patients early use of frovatriptan has been shown to be associated with a greater benefit [12, 28]. Conversely, almotriptan may be useful in those patients requiring a rapid pain relief [16, 17].…”

Section: Discussionmentioning

confidence: 99%

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A double-blind, randomized, multicenter, Italian study of frovatriptan versus almotriptan for the acute treatment of migraine

Bartolini¹,

Giamberardino

Lisotto

et al. 2011

J Headache Pain

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The objective of this study was to evaluate patients’ satisfaction with acute treatment of migraine with frovatriptan or almotriptan by preference questionnaire. One hundred and thirty three subjects with a history of migraine with or without aura (IHS 2004 criteria), with at least one migraine attack in the preceding 6 months, were enrolled and randomized to frovatriptan 2.5 mg or almotriptan 12.5 mg, treating 1–3 attacks. The study had a multicenter, randomized, double blind, cross-over design, with treatment periods lasting <3 months. At study end patients assigned preference to one of the treatments using a questionnaire with a score from 0 to 5 (primary endpoint). Secondary endpoints were pain free and pain relief episodes at 2 and 4 h, and recurrent and sustained pain free episodes within 48 h. Of the 133 patients (86%, intention-to-treat population) 114 of them expressed a preference for a triptan. The average preference score was not significantly different between frovatriptan (3.1 ± 1.3) and almotriptan (3.4 ± 1.3). The rates of pain free (30% frovatriptan vs. 32% almotriptan) and pain relief (54% vs. 56%) episodes at 2 h did not significantly differ between treatments. This was the case also at 4 h (pain free: 56% vs. 59%; pain relief: 75% vs. 72%). Recurrent episodes were significantly (P < 0.05) less frequent under frovatriptan (30% vs. 44%), also for the attacks treated within 30 min. No significant differences were observed in sustained pain free episodes (21% vs. 18%). The tolerability profile was similar between the two drugs. In conclusion, our study suggests that frovatriptan has a similar efficacy of almotriptan in the short-term, while some advantages are observed during long-term treatment.

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Treatment response and tolerability of frovatriptan in patients reporting short- or long-duration migraines at baseline

Cited by 8 publications

References 31 publications

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

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

Symptomatic or prophylactic treatment of weekend migraine: an open-label, nonrandomized, comparison study of frovatriptan versus naproxen sodium versus no therapy

A double-blind, randomized, multicenter, Italian study of frovatriptan versus almotriptan for the acute treatment of migraine

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