September 9, 2005

Switching ‘triptans’ may improve migraine response

NEW YORK (Reuters Health) - There are several so-called
triptan drugs designed for treating migraines -- and if one
doesn't work, another might, German researchers report.

Triptans are recommended as first-line agents for
moderate-to-severe migraine that does not get better with
regular painkillers. However, there are meaningful differences
in efficacy and side effects among the triptans, note Dr.
Hans-Christoph Diener, from University Essen, and colleagues,
in their paper in the journal Headache.

Diener's group recruited some 200 patients who had
experienced unsatisfactory migraine treatment with sumatriptan
(brand name, Imitrex) on at least two occasions. The
participants were randomly given either another triptan,
almotriptan (Axert), to take for their next migraine, or an
inactive placebo tablet.

The percentage of patients who experienced pain relief at 2
hours was significantly higher in the almotriptan group than
the placebo group, 47 percent versus 24 percent. Almotriptan
was also associated with greater sustained pain-free efficacy.

The number of adverse events did not differ significantly
between groups, the researchers note.

These results aren't surprising, Diener and his colleagues
point out, since "migraine patients are not all the same,
migraine headaches are not all the same, and triptans are not
all the same."

They conclude that "when migraine patients respond poorly
to sumatriptan or other triptan treatment, another agent in
this class should be attempted."

SOURCE: Headache, July/August 2005.