Treatment of mild headache in disabled migraine sufferers: results of the Spectrum Study.
OBJECTIVE
To evaluate the effectiveness of sumatriptan, 50-mg tablets, versus placebo for early intervention while head pain was mild in patients with disabling migraine.


METHODS
A post hoc analysis was performed in a subgroup of patients from a large, randomized, placebo-controlled study of patients with disabling headache who treated while pain was mild. Pain-free response 2 and 4 hours postdose, headache recurrence, and safety were examined. Significance tests were performed only for the first-treated attacks.


RESULTS
Twenty-six patients with disabling headache treated 46 mild and 166 moderate or severe headaches. For the first-treated headaches while pain was mild, pain-free rates were significantly higher for sumatriptan than placebo 4 hours postdose (78% versus 0%, P =.02), but not 2 hours postdose (52% versus 0%, P =.22). Across all headaches treated while pain was mild, pain-free responses were higher for sumatriptan than placebo 4 hours (85% versus 17%) and 2 hours (50% versus 0%) postdose compared with placebo. When the same patients treated headaches while pain was moderate or severe, pain-free rates were lower than that reported for treatment during mild pain. There was a trend toward lower headache recurrence in headaches treated while pain was mild compared with moderate or severe pain (13% versus 18%). No drug-related adverse events were reported in the headaches treated while pain was mild.


CONCLUSIONS
Patients with disabling migraine may benefit from early intervention with sumatriptan, 50 mg, while pain is mild.
Cady
R K
RK
Headache Care Center, Springfield, MO 65804, USA.
Lipton
R B
RB
Hall
C
C
Stewart
W F
WF
O'Quinn
S
S
Gutterman
D
D
D000284:Administration, Oral; D000328:Adult; D006233:Persons with Disabilities; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000188:drug therapy* / Q000503:physiopathology*; D012008:Recurrence; D018170:Sumatriptan / Q000009:adverse effects / Q000627:therapeutic use*; D013997:Time Factors; D014662:Vasoconstrictor Agents / Q000009:adverse effects / Q000627:therapeutic use*
D014662:Vasoconstrictor Agents; D018170:Sumatriptan