Almotriptan and Its Combination with Aceclofenac For Migraine Attacks: A Study of Efficacy and The Influence of Auto-Evaluated Brush Allodynia
| Autor: | Luc Herroelen, S. Giurgea, M. Vandenheede, Paul Louis, N. de Klippel, Jean Schoenen, G. Monseu, J. Jacquy |
|---|---|
| Rok vydání: | 2008 |
| Předmět: |
Adult
Male Diclofenac Migraine Disorders Pilot Projects Placebo Logistic regression Physical Stimulation Almotriptan Prevalence medicine Humans business.industry Anti-Inflammatory Agents Non-Steroidal General Medicine Odds ratio Middle Aged medicine.disease Tryptamines Serotonin Receptor Agonists Logistic Models Treatment Outcome Allodynia Migraine Anesthesia Multivariate Analysis Somatosensory Disorders Aceclofenac Drug Therapy Combination Female Neurology (clinical) medicine.symptom business medicine.drug |
| Zdroj: | Cephalalgia. 28:1095-1105 |
| ISSN: | 1468-2982 0333-1024 |
| DOI: | 10.1111/j.1468-2982.2008.01654.x |
| Popis: | Early treatment and combining a triptan with a non-steroidal anti-inflammatory drug (NSAID) are thought to improve outcome during migraine attacks, possibly by counteracting the negative influence of cutaneous allodynia. The aim of this multicentre, double-blind pilot study was to evaluate the prevalence of brush allodynia and its relative influence on the efficacy of a triptan-NSAID combination compared with headache intensity at the time of treatment. In a randomized, cross-over design, 112 migraineurs treated two moderate or severe attacks with almotriptan 12.5 mg combined with either aceclofenac 100 mg or placebo. Patients used a 2-cm brush to assess cutaneous allodynia. Allodynia was reported in 34.4± of attacks. The almotriptan-aceclofenac combination was numerically superior to triptan-placebo on 2-24-h sustained pain-free ( P = 0.07), 2-h pain-free ( P = 0.07) and headache recurrence ( P = 0.05) rates, but not on 1-h headache relief. Allodynia numerically reduced treatment success overall, but this effect was not significant for the primary outcome measures. Headache intensity had a significant negative influence on 1-h relief in both attacks ( P = 0.0001 and 0.0008, X2) and on 2-24-h sustained pain-free rates in triptanplacebo-treated attacks ( P = 0.013). Multivariate logistic regression analysis confirmed that headache intensity at treatment intake, rather than allodynia, significantly influenced most outcome measures, predominantly so in attacks treated with almotriptan and aceclofenac. In the latter, severe compared with moderate headache intensity reduced the likelihood of achieving the primary efficacy end-points [odds ratios (OR) 0.12 and 0.33], whereas allodynia was not a significant explanatory variable (OR 0.76 and 0.65). The results apply to the protocol used here and need to be confirmed in larger studies using quantitative sensory testing. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|