Sumatriptan nasal spray: a dose-ranging study in the acute treatment of migraine.
This multicentre, randomized, double-blind, placebo-controlled, parallel group dose-ranging study compared the efficacy and tolerability of four doses of sumatriptan nasal spray (2.5, 5, 10 and 20 mg) with a placebo, in the acute treatment of a single migraine attack. In total, 544 patients received the study medication as a single spray in one nostril, to treat a single migraine attack in the clinic. Efficacy assessments included the measurement of headache severity, clinical disability, and the presence/absence of associated symptoms. The incidence of headache recurrence was also assessed. The three highest doses of sumatriptan (5 mg 49%, 10 mg 46%, 20 mg 64%) were significantly better than the placebo (25%) at providing headache relief (moderate or severe headache improving to mild or none) 120 min after treatment (P </= 0. 01). Also, the 20 mg dose was significantly superior to both the 10 and 5 mg doses at this time point (P < 0.05). The proportion of patients who were headache-free 120 min after treatment, was also higher following 20 mg (42%) rather than following any other sumatriptan dose (14-24%, P < 0.005 20 vs 10 mg) or placebo (11%). Headache recurrence in patients who had responded to initial treatment was reported by 30-41% of patients who received sumatriptan, compared with 33% of patients in the placebo group. Sumatriptan nasal spray was well tolerated, the incidence of adverse events with each dose of sumatriptan being similar to the placebo (20-27 and 23%, respectively). Apart from bad/bitter taste, the events were comparable with those reported following sumatriptan treatment by other routes of administration.
Peikert
A
A
Stadtirches Klinikum Sanatoriumsplatz 2, 81545 Munchen-Harlaching, Germany.
Becker
W J
WJ
Ashford
E A
EA
Dahlof
C
C
Hassani
H
H
Salonen
R J
RJ
D000328:Adult; D000336:Aerosols; D004305:Dose-Response Relationship, Drug; D004562:Electrocardiography; D005260:Female; D006321:Heart / Q000187:drug effects; D006801:Humans; D012001:Hyperacusis / Q000188:drug therapy / Q000209:etiology; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D009325:Nausea / Q000188:drug therapy / Q000209:etiology; D017060:Patient Satisfaction; D020795:Photophobia / Q000188:drug therapy / Q000209:etiology; D012008:Recurrence; D016879:Salvage Therapy; D018170:Sumatriptan / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D014662:Vasoconstrictor Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D014839:Vomiting / Q000188:drug therapy / Q000209:etiology
D000336:Aerosols; D014662:Vasoconstrictor Agents; D018170:Sumatriptan