Abstract | OBJECTIVE: BACKGROUND: METHODS: Post-hoc analysis of data from a randomized, controlled trial of telcagepant (150 mg, 300 mg) zolmitriptan 5 mg, or placebo for a moderate/severe migraine. Responder rates were analyzed according to patients' self-reported historical triptan response (HTR): (1) good HTR (N = 660): response in 75-100% of attacks; (2) intermediate HTR (N = 248): response in 25-74% of attacks; (3) poor HTR/no use (N = 407): response in < 25% of attacks, or patient did not take triptans. A limitation of the analysis is that the last subgroup comprised mainly (91%) patients who reported that they did not take triptans, but it was not known whether these patients were triptan-naïve or had previously used triptans and stopped taking them. RESULTS: For zolmitriptan, 2-hour pain relief rates were higher in the good HTR subgroup (116/162, 72%) than in the intermediate (29/62, 47%) and poor/no use (44/111, 40%) HTR subgroups. The 2-hour pain relief rates were similar across HTR subgroups for telcagepant 150 mg (48-58%), 300 mg (52-58%), and placebo (26-31%). In the poor/no use HTR subgroup, more patients receiving telcagepant 300 mg (56/98, 57.1%) had 2-hour pain relief than those receiving zolmitriptan (44/111, 39.6%; odds ratio = 2.11 [95% CI: 1.20,3.71], P = .009); the percentage for telcagepant 150 mg (57/119, 47.9%) was not significantly different from zolmitriptan (odds ratio = 1.41 [95% CI: 0.82, 2.40], P = .211). CONCLUSIONS: This suggests that different patients may respond to triptans or telcagepant 300 mg. Caution should be exercised in interpreting the results because of the post-hoc nature of the analysis (clinical trial registry: NCT00442936).
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Authors | Tony W Ho, Jes Olesen, David W Dodick, James Kost, Christopher Lines, Michel D Ferrari |
Journal | Headache
(Headache)
Vol. 51
Issue 1
Pg. 64-72
(Jan 2011)
ISSN: 1526-4610 [Electronic] United States |
PMID | 21054362
(Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Copyright | © 2010 American Headache Society. |
Chemical References |
- Azepines
- Calcitonin Gene-Related Peptide Receptor Antagonists
- Imidazoles
- Oxazolidinones
- Tryptamines
- zolmitriptan
- telcagepant
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Topics |
- Adult
- Azepines
(adverse effects, therapeutic use)
- Calcitonin Gene-Related Peptide Receptor Antagonists
- Double-Blind Method
- Female
- Humans
- Imidazoles
(adverse effects, therapeutic use)
- Male
- Migraine Disorders
(drug therapy)
- Oxazolidinones
(adverse effects, therapeutic use)
- Pain
(prevention & control)
- Surveys and Questionnaires
- Tryptamines
(adverse effects, therapeutic use)
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