Tags

Type your tag names separated by a space and hit enter

Double-blind clinical trials of oral triptans vs other classes of acute migraine medication - a review.
Cephalalgia. 2004 May; 24(5):321-32.C

Abstract

Although the migraine clinical trials literature is enormous, we identified only nine published double-blind studies which compare an oral triptan with a non-triptan acute treatment. Of the nine comparative trials that met inclusion criteria for this review, six compared sumatriptan with other drugs, zolmitriptan was studied in two trials and eletriptan in one trial. In seven of the nine studies reviewed herein, differences between active treatments on the primary endpoints were not dramatic. Experience in clinical practice suggests that, for many patients, oral triptans are superior to non-specific acute treatments, creating a discrepancy between clinical trials results and clinical practice experience. Four possible explanations for the disparities between clinical trials and clinical practice are likely: (i) statistically significant differences may not have emerged because the studies lack adequate statistical power; (ii) patients treated with triptans in clinical practice may be relatively more responsive to triptans and relatively less responsive to other agents than those who participate in clinical trials (patient selection); (iii) headache response at 2 h, as measured in clinical trials, may not fully capture the benefits of triptans relative to other therapies, as assessed in clinical practice; (iv) waiting until pain is moderate or severe, as required in clinical trials, may disadvantage triptans relative to comparators.

Authors+Show Affiliations

Department of Neurology, Albert Einstein College of Medicine, Bronx, New York 10461, USA. Rlipton@aecom.yu.eduNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Review

Language

eng

PubMed ID

15096220

Citation

Lipton, R B., et al. "Double-blind Clinical Trials of Oral Triptans Vs Other Classes of Acute Migraine Medication - a Review." Cephalalgia : an International Journal of Headache, vol. 24, no. 5, 2004, pp. 321-32.
Lipton RB, Bigal ME, Goadsby PJ. Double-blind clinical trials of oral triptans vs other classes of acute migraine medication - a review. Cephalalgia. 2004;24(5):321-32.
Lipton, R. B., Bigal, M. E., & Goadsby, P. J. (2004). Double-blind clinical trials of oral triptans vs other classes of acute migraine medication - a review. Cephalalgia : an International Journal of Headache, 24(5), 321-32.
Lipton RB, Bigal ME, Goadsby PJ. Double-blind Clinical Trials of Oral Triptans Vs Other Classes of Acute Migraine Medication - a Review. Cephalalgia. 2004;24(5):321-32. PubMed PMID: 15096220.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Double-blind clinical trials of oral triptans vs other classes of acute migraine medication - a review. AU - Lipton,R B, AU - Bigal,M E, AU - Goadsby,P J, PY - 2004/4/21/pubmed PY - 2004/6/18/medline PY - 2004/4/21/entrez SP - 321 EP - 32 JF - Cephalalgia : an international journal of headache JO - Cephalalgia VL - 24 IS - 5 N2 - Although the migraine clinical trials literature is enormous, we identified only nine published double-blind studies which compare an oral triptan with a non-triptan acute treatment. Of the nine comparative trials that met inclusion criteria for this review, six compared sumatriptan with other drugs, zolmitriptan was studied in two trials and eletriptan in one trial. In seven of the nine studies reviewed herein, differences between active treatments on the primary endpoints were not dramatic. Experience in clinical practice suggests that, for many patients, oral triptans are superior to non-specific acute treatments, creating a discrepancy between clinical trials results and clinical practice experience. Four possible explanations for the disparities between clinical trials and clinical practice are likely: (i) statistically significant differences may not have emerged because the studies lack adequate statistical power; (ii) patients treated with triptans in clinical practice may be relatively more responsive to triptans and relatively less responsive to other agents than those who participate in clinical trials (patient selection); (iii) headache response at 2 h, as measured in clinical trials, may not fully capture the benefits of triptans relative to other therapies, as assessed in clinical practice; (iv) waiting until pain is moderate or severe, as required in clinical trials, may disadvantage triptans relative to comparators. SN - 0333-1024 UR - https://www.unboundmedicine.com/medline/citation/15096220/Double_blind_clinical_trials_of_oral_triptans_vs_other_classes_of_acute_migraine_medication___a_review_ L2 - https://journals.sagepub.com/doi/10.1111/j.1468-2982.2003.00690.x?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -