Oral sumatriptan: effect of a second dose, and incidence and treatment of headache recurrences
| Autor: | A.J. Pilgrim, Ferrari, BA Anderson, MH James, G Nappi, E. Ashford, David W. Bates |
|---|---|
| Rok vydání: | 1994 |
| Předmět: |
Adult
Male medicine.medical_treatment Migraine Disorders Administration Oral Multiple dose Drug Administration Schedule Central nervous system disease Double-Blind Method Oral administration Recurrence medicine Humans Chemotherapy business.industry Vascular disease Sumatriptan Incidence (epidemiology) General Medicine Middle Aged musculoskeletal system medicine.disease Migraine Anesthesia cardiovascular system Female Neurology (clinical) business medicine.drug |
| Zdroj: | Cephalalgia : an international journal of headache. 14(5) |
| ISSN: | 0333-1024 |
| Popis: | Oral sumatriptan in a dose of 100 mg aborts about 60% of migraine attacks within 2 h, but the headache may recur within 24 h. We investigated: (i) the incidence of headache recurrence after oral sumatriptan, (ii) whether a second tablet of sumatriptan at 2 h increases initial efficacy and/or (iii) prevents headache recurrence and (iv) whether a further tablet of sumatriptan treats headache recurrence. In a randomized, parallel-group clinical trial, 1246 patients treated one to three migraine attacks (with or without aura) with 100 mg oral sumatriptan. Two hours later they all took a double-blind randomized second tablet of sumatriptan (group I) or placebo (group II). Patients who initially improved, but then experienced headache recurrence took a further double-blind randomized tablet of sumatriptan or placebo. Proportions of patients who improved from moderate/severe headache to mild/none were similar in groups I and II at 2 h (55 vs 56%) and 4 h (80 vs 77%). Incidences of headache recurrence (moderate/severe-any grade of headache) and median times to headache recurrence were also similar: 22–32% at 16 h in group I and 25–33% at 16.5 h in group II. Sumatriptan was superior to placebo in treating headache recurrence: 74 vs 49% ( p = 0.017) in group I and 70 vs 30% ( p = 0.0001) in group II. Thus, one-fourth of patients experience headache recurrence at about 16 h after successful treatment of a migraine attack with 100 mg oral sumatriptan. A second tablet of sumatriptan at 2 h does not increase initial efficacy and neither prevents nor delays headache recurrence. A further tablet of sumatriptan is, however, highly effective in treating headache recurrence. All dose regimens were well tolerated. |
| Databáze: | OpenAIRE |
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