Clinical benefits of early triptan therapy for migraine.
The introduction of the triptans brought advances in achieving complete and sustained pain resolution in migraine patients, compared with non-migraine-specific treatments. However, sustained pain-free rates for triptans recorded in many clinical trials are still relatively low. This may be due to study participants being treated late into the attack, when pain is already moderate or severe. Studies with almotriptan have shown that efficacy is enhanced when treatment is given early in a migraine attack while pain is still mild, compared with later administration when pain intensity is greater. Developments in our understanding of migraine pathophysiology provide a rationale for this phenomenon, with improved efficacy seen when abortive treatment is administered before central sensitization develops. A limited window of therapeutic opportunity exists early in an attack to improve the outcome of triptan treatment. Early intervention is recommended to avoid the significant pain and disability commonly associated with moderate or severe migraine.
Láinez
Mja
M
Department of Neurology, Hospital Clínico Universitario, University of Valencia, Valencia, Spain. jlaineza@meditex.es
D000208:Acute Disease; D000700:Analgesics / Q000009:adverse effects / Q000627:therapeutic use*; D001294:Attitude to Health; D002986:Clinical Trials as Topic; D018450:Disease Progression; D019317:Evidence-Based Medicine / Q000379:methods; D006801:Humans; D007211:Indoles / Q000009:adverse effects / Q000627:therapeutic use*; D008881:Migraine Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology* / Q000517:prevention & control; D017060:Patient Satisfaction; D010818:Practice Patterns, Physicians'; D055502:Secondary Prevention; D017366:Serotonin Receptor Agonists / Q000627:therapeutic use; D016896:Treatment Outcome; D014363:Tryptamines
D000700:Analgesics; D007211:Indoles; D017366:Serotonin Receptor Agonists; D014363:Tryptamines; C409045:almotriptan