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Early treatment in migraine: how strong is the current evidence?
Cephalalgia. 2008 Sep; 28 Suppl 2:28-35.C

Abstract

Over the last 10 years, triptans (serotonin 5-HT(1B/1D) receptor agonists) have proved to be efficacious in treating migraine pain. However, recent evidence suggests that patients are still not receiving optimal pain management, particularly in clinical trials, where triptan treatment is generally not initiated until pain has reached moderate intensity. Pathophysiological evidence indicates that if treatment is initiated at an early stage, while pain is still mild and before the onset of central sensitization, outcomes for patients may be improved. In addition, a small number of clinical trials have been reported in which triptans were taken early (within 1 h of pain onset) or while pain was still mild; although constraints of trial design and data analysis limit definite conclusions, overall the results suggest that this early/mild approach results in more rapid and sustained pain relief. New studies are therefore needed to clarify the clinical benefits of early treatment, whilst taking into account potential risks, such as medication overuse. Ultimately, migraine treatment strategies require optimization in order to meet patient expectations and to reduce the current burden of migraine-associated disability.

Authors+Show Affiliations

Klinik für Neurologie, Universitätsklinik Essen, Essen, Germany. astrid.gendolla@uni-due.de

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

18715330

Citation

Gendolla, A. "Early Treatment in Migraine: How Strong Is the Current Evidence?" Cephalalgia : an International Journal of Headache, vol. 28 Suppl 2, 2008, pp. 28-35.
Gendolla A. Early treatment in migraine: how strong is the current evidence? Cephalalgia. 2008;28 Suppl 2:28-35.
Gendolla, A. (2008). Early treatment in migraine: how strong is the current evidence? Cephalalgia : an International Journal of Headache, 28 Suppl 2, 28-35. https://doi.org/10.1111/j.1468-2982.2008.01688.x
Gendolla A. Early Treatment in Migraine: How Strong Is the Current Evidence. Cephalalgia. 2008;28 Suppl 2:28-35. PubMed PMID: 18715330.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Early treatment in migraine: how strong is the current evidence? A1 - Gendolla,A, PY - 2008/9/6/pubmed PY - 2008/12/17/medline PY - 2008/9/6/entrez SP - 28 EP - 35 JF - Cephalalgia : an international journal of headache JO - Cephalalgia VL - 28 Suppl 2 N2 - Over the last 10 years, triptans (serotonin 5-HT(1B/1D) receptor agonists) have proved to be efficacious in treating migraine pain. However, recent evidence suggests that patients are still not receiving optimal pain management, particularly in clinical trials, where triptan treatment is generally not initiated until pain has reached moderate intensity. Pathophysiological evidence indicates that if treatment is initiated at an early stage, while pain is still mild and before the onset of central sensitization, outcomes for patients may be improved. In addition, a small number of clinical trials have been reported in which triptans were taken early (within 1 h of pain onset) or while pain was still mild; although constraints of trial design and data analysis limit definite conclusions, overall the results suggest that this early/mild approach results in more rapid and sustained pain relief. New studies are therefore needed to clarify the clinical benefits of early treatment, whilst taking into account potential risks, such as medication overuse. Ultimately, migraine treatment strategies require optimization in order to meet patient expectations and to reduce the current burden of migraine-associated disability. SN - 1468-2982 UR - https://www.unboundmedicine.com/medline/citation/18715330/Early_treatment_in_migraine:_how_strong_is_the_current_evidence DB - PRIME DP - Unbound Medicine ER -