Sumatriptan 6 mg subcutaneous as an effective migraine treatment in patients with cutaneous allodynia who historically fail to respond to oral triptans.
The objective of the study was to assess the efficacy of 6 mg subcutaneous (s.c.) sumatriptan to treat migraine and the relationship between response of migraine and cutaneous allodynia in a population of migraine patients who historically failed to respond to oral triptan medications. This was an open-label study consisting of patients with migraines who historically failed to respond to oral triptan medications. Forty-three patients were asked to treat three migraine attacks with 6 mg s.c. sumatriptan. The primary efficacy endpoint was the percentage of patients achieving relief of headache at 2 h. Ninety-one percent of the patients responded to a single dose of s.c. sumatriptan 6 mg. Fifty percent of all patients were pain-free by 2 h and over 30% had a 24-h sustained pain-free response. When administered within 90 min from the onset of migraine (i.e., during the developing phase of cutaneous allodynia), s.c. 6 mg sumatriptan proved to be effective despite the occurrence of allodynia in a group of patients, who historically had failed to respond to oral triptan medications. These findings suggest that the window of opportunity to treat allodynic patients with injectable triptans may be longer (up to 2 h) than with oral triptans (up to 1 h).
Diamond
Seymour
S
Diamond Headache Clinic, 467 West Deming Place, Suite 500, Chicago, IL 60614, USA. MACF48@aol.com
Freitag
Fred G
FG
Feoktistov
Alexander
A
Nissan
George
G
D000284:Administration, Oral; D000328:Adult; D004361:Drug Tolerance; D005260:Female; D006801:Humans; D006941:Hyperesthesia / Q000503:physiopathology; D007279:Injections, Subcutaneous / Q000379:methods; D008875:Middle Aged; D008881:Migraine Disorders / Q000188:drug therapy*; D010147:Pain Measurement; D017366:Serotonin Receptor Agonists / Q000008:administration & dosage*; D012867:Skin / Q000503:physiopathology; D018170:Sumatriptan / Q000627:therapeutic use*; D014363:Tryptamines / Q000008:administration & dosage*; D014662:Vasoconstrictor Agents / Q000627:therapeutic use*
D017366:Serotonin Receptor Agonists; D014363:Tryptamines; D014662:Vasoconstrictor Agents; D018170:Sumatriptan