Patients' preference for triptans and other medications as a tool for assessing the efficacy of acute treatments for migraine.
Oral triptans are effective and well tolerated acute treatments for migraine, but clinical differences between them are small and difficult to measure in conventional clinical trials. Patient preference assesses a global measure of efficacy and tolerability, and may be a more sensitive means of distinguishing between these drugs. In a series of studies, patients consistently expressed a clear preference for triptans over their usual non-triptan acute medications, e.g., analgesics and ergotamine. Direct comparator studies of patient preference with oral triptans showed that patients could distinguish between different triptans, and between different formulations of the same triptan. Patients could even distinguish between the three oral doses of sumatriptan. The most frequently provided reasons for preference were speed of response and overall effectiveness. Patient preference is a sensitive clinical trial endpoint and physicians should consider using it when reviewing the efficacy of acute migraine medications.
Dowson
Andrew J
AJ
King's Headache Service, King's College Hospital, Denmark Hill, London SE5 9RS, UK. andydowson@psim-limited.com
Tepper
Stewart J
SJ
Dahlöf
Carl
C
D000284:Administration, Oral; D000700:Analgesics / Q000627:therapeutic use; D002986:Clinical Trials as Topic / Q000592:standards / Q000706:statistics & numerical data; D004305:Dose-Response Relationship, Drug; D004878:Ergotamine / Q000627:therapeutic use; D019538:Health Care Surveys; D006801:Humans; D008881:Migraine Disorders / Q000188:drug therapy* / Q000523:psychology; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D014363:Tryptamines / Q000627:therapeutic use*
D000700:Analgesics; D014363:Tryptamines; D004878:Ergotamine