Correlation between lipophilicity and triptan outcomes.
BACKGROUND
It has been suggested that triptans achieving higher central nervous system (CNS) levels should have an advantage in efficacy, if central actions are important. Objective.-Our aim was to correlate the efficacy and tolerability results of triptans with their lipophilicity.


METHODS
Data for response and pain free at 2 hours, recurrence, adverse events (AE), CNS AE, and chest symptoms taken from Ferrari et al's meta-analysis publications for the recommended doses of oral triptans were correlated with their lipophilicity coefficients (logD(pH)7.4 = -2.1 almotriptan < -1.5 sumatriptan < -1.0 zolmitriptan < -0.7 rizatriptan < -0.2 naratriptan < 0.5 eletriptan).


RESULTS
We found no significant correlation between lipophilicity coefficients and any of the analyzed parameters. There was, however, some correlation between lipophilicity and CNS AE (P = .09, r = 0.74) and, to a lesser degree, with a reduction in recurrence rate (r = -0.36). The r values for response and pain free with placebo correction ranged from 0.04 to 0.34, suggesting almost no correlation between lipophilicity and efficacy variables.


CONCLUSIONS
According to this analysis, a higher lipophilicity does not seem crucial to improve triptan efficacy. This physico-chemical property, however, correlates with higher CNS AE and, possibly, lower recurrence rates.
Pascual
Julio
J
University Hospital M de Valdecilla, 39008 Santander, Spain.
Muñoz
Pedro
P
D002493:Central Nervous System Diseases / Q000139:chemically induced; D055598:Chemical Phenomena; D002627:Chemistry, Physical; D006801:Humans; D007211:Indoles / Q000009:adverse effects / Q000737:chemistry / Q000627:therapeutic use; D008881:Migraine Disorders / Q000188:drug therapy*; D023303:Oxazolidinones / Q000009:adverse effects / Q000737:chemistry / Q000627:therapeutic use; D010880:Piperidines / Q000009:adverse effects / Q000737:chemistry / Q000627:therapeutic use; D017366:Serotonin Receptor Agonists / Q000009:adverse effects / Q000737:chemistry* / Q000627:therapeutic use*; D013223:Statistics as Topic; D018170:Sumatriptan / Q000009:adverse effects / Q000737:chemistry / Q000627:therapeutic use; D016896:Treatment Outcome; D014230:Triazoles / Q000009:adverse effects / Q000737:chemistry / Q000627:therapeutic use; D014363:Tryptamines
D007211:Indoles; D023303:Oxazolidinones; D010880:Piperidines; D017366:Serotonin Receptor Agonists; D014230:Triazoles; D014363:Tryptamines; C409045:almotriptan; C089750:zolmitriptan; C093622:rizatriptan; D018170:Sumatriptan; C106783:naratriptan