[Spanish contribution to the clinical development of eletriptan: an analysis of controlled studies].
BACKGROUND
Eletriptan is a recently marketed second-generation triptan with a potent agonist activity on 5-HT1B/ 1D receptors. Our aim has been to analyze the specific results from the Spanish participation in phase IIIa and IIIb clinical trials vs placebo and compare them with the results obtained in the global clinical development of eletriptan.


METHODS
Analysis of the results obtained in 40 centers in Spain (358 patients) vs global sample 4,677 patients) for the first migraine attack in 6 controlled clinical trials with eletriptan 40 mg, eletriptan 80 mg and placebo. This ad hoc analysis was carried out for those treatment groups with more than 50 patients, which reduced the final number of patients from Spain to 250.


RESULTS
The proportion of patients with relief at 2 hours (main endpoint) in the Spanish sample was 22 %, 59 % and 67 % for placebo, eletriptan 40 mg and eletriptan 80 mg, respectively. These values were significantly higher (p < 0.05) than those of placebo and similar to those from the total sample. The proportion of pain free patients at 2 hours in the Spanish sample was 10 %, 36 % and 41 % for placebo, eletriptan 40 mg and eletriptan 80 mg, respectively. These values were significantly better than those for placebo (p < 0.05) and about 15 %-20 % higher than those from the total sample. Recurrence rate in the Spanish sample was 50 %, 16 % and 25 % for placebo, eletriptan 40 and eletriptan 80 mg, respectively, and did not differ from that of the total sample. Sustained relief for the two eletriptan doses was 46 % for both eletriptan 40 and eletriptan 80, this being significant (p < 0.05) over placebo (11 %) for the Spanish sample and similar to that of the global sample. The results for other efficacy parameters, such as need of rescue medication, functional response at 2 hours, complete response for pain-freeness and acceptability followed a similar pattern. Eletriptan was, in general, well-tolerated. Adverse events were slight-moderate in intensity, transient and were not different, either in profile or proportion, from those from the global sample.


CONCLUSIONS
These results confirm eletriptan 40 mg and 80 mg as an excellent option for the symptomatic treatment of migraine in our setting.
Pascual
J
J
Servicio de Neurología, Hospital Universitario Marqués de Valdecilla, Santander. juliopascual@telefonica.net
Leira
R
R
Lainez
J M
JM
Liaño
H
H
Díez-Tejedor
E
E
Navarro
A
A
Jiménez
D
D
Ezpeleta
D
D
Mateos
V
V
Madrigal
M
M
Palacios
G
G
D017326:Clinical Trials, Phase III as Topic; D004305:Dose-Response Relationship, Drug; D006801:Humans; D007211:Indoles / Q000627:therapeutic use*; D008881:Migraine Disorders / Q000188:drug therapy*; D010919:Placebos; D011759:Pyrrolidines / Q000627:therapeutic use*; D044302:Receptor, Serotonin, 5-HT1B / Q000378:metabolism; D044346:Receptor, Serotonin, 5-HT1D / Q000378:metabolism; D017366:Serotonin Receptor Agonists / Q000627:therapeutic use*; D013030:Spain; D016896:Treatment Outcome; D014363:Tryptamines
D007211:Indoles; D010919:Placebos; D011759:Pyrrolidines; D044302:Receptor, Serotonin, 5-HT1B; D044346:Receptor, Serotonin, 5-HT1D; D017366:Serotonin Receptor Agonists; D014363:Tryptamines; C115647:eletriptan