Document Detail


Infrequent or non-response to oral sumatriptan does not predict response to other triptans--review of four trials.
MedLine Citation:
PMID:  16426262     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A migraineur can claim to be an infrequent responder ('non-responder') to an oral triptan independent of which triptan he or she is presently using. Four trials of an alternative triptan (zolmitriptan/rizatriptan; eletriptan; naratriptan; almotriptan) in patients with a history of infrequent response to oral sumatriptan were compared and contrasted in terms of study design, patient characteristics, and efficacy and tolerability of the triptan under investigation. Unfortunately, none of the reported studies used an appropriate parallel design, which would have had the non-responding triptan (oral sumatriptan) in one arm and without encapsulation. While the four trials differed in terms of study design (open-label vs. placebo-controlled), definition of sumatriptan 'non-responder' (retrospective vs. prospective) and pain intensity at baseline (30% severe to 70% severe), all four demonstrated that lack of response to sumatriptan did not predict lack of response to an alternative triptan. Changing triptans resulted in 2-h pain-relief rates of 25-81% in patients with a history of poor response to sumatriptan. It can be concluded that migraine patients who respond infrequently to sumatriptan should be switched to a different triptan, as lack of response to one triptan does not predict likelihood of responsiveness to another. A review of the available evidence suggests that almotriptan may be one of the most appropriate choices for an alternative triptan.
Authors:
C G H Dahlöf
Publication Detail:
Type:  Comparative Study; Journal Article; Meta-Analysis; Review    
Journal Detail:
Title:  Cephalalgia : an international journal of headache     Volume:  26     ISSN:  0333-1024     ISO Abbreviation:  Cephalalgia     Publication Date:  2006 Feb 
Date Detail:
Created Date:  2006-01-23     Completed Date:  2006-03-29     Revised Date:  2008-02-11    
Medline Journal Info:
Nlm Unique ID:  8200710     Medline TA:  Cephalalgia     Country:  England    
Other Details:
Languages:  eng     Pagination:  98-106     Citation Subset:  IM    
Affiliation:
Gothenburg Migraine Clinic, Gothenburg, Sweden. carl.dahlof@migraineclinic.se
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MeSH Terms
Descriptor/Qualifier:
Administration, Oral
Clinical Trials as Topic*
Humans
Migraine Disorders / drug therapy*,  epidemiology*
Outcome Assessment (Health Care)
Serotonin Agonists / administration & dosage
Sumatriptan / administration & dosage*
Treatment Failure*
Treatment Outcome
Tryptamines / administration & dosage,  classification
Vasoconstrictor Agents / administration & dosage
Chemical
Reg. No./Substance:
0/Serotonin Agonists; 0/Tryptamines; 0/Vasoconstrictor Agents; 103628-46-2/Sumatriptan

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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