The efficacy of subcutaneous sumatriptan in the treatment of recurrence of migraine headache.
OBJECTIVE
To investigate the efficacy of a second subcutaneous dose of 6 mg sumatriptan in the treatment of recurrence of headache after successful treatment of a migraine attack with an initial 6 mg dose.


METHODS
In a prospective, randomised, placebo controlled, double blind, parallel group study, 803 patients were treated for one to three migraine attacks with severe or moderate headache with a subcutaneous injection of 6 mg sumatriptan. Any subsequent recurrence of migraine headache was treated with a randomised second injection of sumatriptan or placebo. Recurrence was defined as a headache of moderate or severe intensity occurring 1-24 hours after the initial dose in a patient whose headache had been relieved by sumatriptan (reduction of headache severity from severe or moderate to mild or none after one hour).


RESULTS
Headache recurrence was reported by 10%-15% of patients. At each attack, 6 mg sumatriptan given subcutaneously was significantly (P < 0.0005) more effective than placebo at relieving recurrent headache after one hour (84%-93% v 31%-50% of patients); 76%-83% of patients reported headache relief one hour after the initial dose of sumatriptan. Sumatriptan was generally well tolerated.


CONCLUSIONS
Up to 15% of patients with migraine experience significant recurrence of headache after successful treatment with subcutaneous sumatriptan, and this recurrence is effectively treated by a further dose of subcutaneous sumatriptan.
Cull
R E
RE
Department of Clinical Neurosciences, Western General Hospital, Edinburgh, UK.
Price
W H
WH
Dunbar
A
A
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007279:Injections, Subcutaneous; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000188:drug therapy*; D010919:Placebos; D011446:Prospective Studies; D012008:Recurrence; D012720:Severity of Illness Index; D018170:Sumatriptan / Q000008:administration & dosage* / Q000627:therapeutic use*; D016896:Treatment Outcome; D014662:Vasoconstrictor Agents / Q000008:administration & dosage* / Q000627:therapeutic use*
D010919:Placebos; D014662:Vasoconstrictor Agents; D018170:Sumatriptan