Document Detail


A double-blind study of subcutaneous dihydroergotamine vs subcutaneous sumatriptan in the treatment of acute migraine.
MedLine Citation:
PMID:  8639069     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To assess the efficacy and tolerability of subcutaneous dihydroergotamine mesylate (DHE-45) vs subcutaneous sumatriptan succinate (Imitrex) for the treatment of acute migraine with or without aura. DESIGN: Double-blind, randomized trial with parallel treatment arms. SETTING: Clinics and private neurology practices. SUBJECTS: Patients of either sex, with migraine with or without aura, between the ages of 18 and 65 years. INTERVENTIONS: Patients with moderate or severe head pain were randomized to receive either 1 mg of subcutaneous dihydroergotamine mesylate or 6 mg of subcutaneous sumatriptan succinate. Patients rated head pain, functional ability, nausea, and vomiting at baseline and at 0.5, 1, 2, 4, and 24 hours after the injection. Presence or absence of headache at 3 hours was calculated from collected data. If pain persisted after 2 hours, a second injection of the same study medication was allowed, and self-ratings were repeated 30 and 60 minutes later. Follow-up data were collected at 24 hours. MAIN OUTCOME MEASURES: Relief of head pain and recurrence of successfully treated headache. RESULTS: There were 295 evaluable patients. At 2 hours, 73.1% of the patients treated with dihydroergotamine and 85.3% of those treated with sumatriptan had relief (P = .002). There was no statistical difference in headache relief between the groups at 3 or 4 hours. Headache relief was achieved by 85.5% of those treated with dihydroergotamine and by 83.3% of those treated with sumatriptan by 4 hours. By 24 hours 89.7% of dihydroergotamine-treated patients and 76.7% of sumatriptan-treated patients had relief (P = .004). Headache recurred within 24 hours after treatment in 45% of the sumatriptan-treated patients and in 17.7% of the dihydroergotamine-treated patients (P < or = .001). CONCLUSIONS: Both sumatriptan and dihydroergotamine were effective in aborting migraine headaches. Headache recurrence was two and a half time as likely with sumatriptan as with dihydroergotamine.
Authors:
P Winner; O Ricalde; B Le Force; J Saper; B Margul
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Archives of neurology     Volume:  53     ISSN:  0003-9942     ISO Abbreviation:  Arch. Neurol.     Publication Date:  1996 Feb 
Date Detail:
Created Date:  1996-07-05     Completed Date:  1996-07-05     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0372436     Medline TA:  Arch Neurol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  180-4     Citation Subset:  AIM; IM    
Affiliation:
Palm Beach Headache Center, Fla, USA.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adolescent
Adult
Aged
Analgesics, Non-Narcotic / administration & dosage,  therapeutic use*
Dihydroergotamine / administration & dosage,  therapeutic use*
Double-Blind Method
Female
Humans
Injections, Subcutaneous
Male
Middle Aged
Migraine Disorders / drug therapy*
Prospective Studies
Recurrence
Serotonin Agonists / administration & dosage,  therapeutic use*
Sumatriptan / administration & dosage,  therapeutic use*
Chemical
Reg. No./Substance:
0/Analgesics, Non-Narcotic; 0/Serotonin Agonists; 103628-46-2/Sumatriptan; 511-12-6/Dihydroergotamine
Comments/Corrections
Comment In:
Arch Neurol. 1996 Dec;53(12):1215-6   [PMID:  8970446 ]

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


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