Identification of negative predictors of pain-free response to triptans: analysis of the eletriptan database.

Abstract

Thirty to forty percent of migraineurs do not respond to any given triptan treatment. We identified clinical variables that significantly predict therapeutic non-response and evaluated the efficacy of eletriptan (20, 40 and 80 mg) and sumatriptan (100 mg) vs. placebo in a subgroup of patients with all predictor variables. First-attack data were pooled from 10 randomized, double-blind, placebo-controlled migraine trials (n = 8473). Multivariate regression analyses identified three significant baseline predictors of failure to achieve 2-h pain-free response: severe headache pain, presence of photophobia/phonophobia and presence of nausea. Time of dosing following headache onset did not influence 2-h pain-free response. Among patients with all three risk factors (n = 2010; 24% of total sample), 2-h pain-free response was significantly higher in patients receiving all three doses of eletriptan or sumatriptan vs. placebo (all P < 0.01). Thus, eletriptan and sumatriptan are efficacious in difficult-to-treat patients at high risk for non-response to triptans.

• Authors: H-C Diener, D W Dodick, P J Goadsby, R B Lipton, M Almas, B Parsons
• Journal: Cephalalgia : an international journal of headache (Cephalalgia) Vol. 28 Issue 1 Pg. 35-40 (Jan 2008) ISSN: 1468-2982 [Electronic] England
• PMID: 17941878 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Pyrrolidines
• Tryptamines
• eletriptan

Topics

• Adult
• Databases, Factual
• Double-Blind Method
• Female
• Humans
• Hyperacusis (complications, drug therapy, epidemiology)
• Male
• Middle Aged
• Migraine Disorders (complications, drug therapy, epidemiology)
• Multicenter Studies as Topic (methods)
• Nausea (complications, drug therapy, epidemiology)
• Pain (complications, drug therapy, epidemiology)
• Photophobia (complications, drug therapy, epidemiology)
• Predictive Value of Tests
• Pyrrolidines (therapeutic use)
• Randomized Controlled Trials as Topic (methods)
• Time Factors
• Tryptamines (therapeutic use)