title: Crossover, double-blind clinical trial comparing almotriptan and ergotamine plus caffeine for acute migraine therapy.
abstract: In this randomized, double-blind, crossover clinical trial, adult patients treated two migraine attacks: one with almotriptan 12.5 mg and the other with ergotamine 2 mg plus caffeine 200 mg. Treatment with almotriptan was associated with a significantly greater proportion of patients achieving 2-h pain free (20.9% vs. 13.7%; P < 0.05) and 2-h pain relief (57.7% vs. 44.5%; P < 0.01) compared with ergotamine plus caffeine therapy; significant differences were not seen at 1 h. Rates for sustained pain free and sustained pain free plus no adverse events (AEs) also were significantly greater after almotriptan treatment than after the use of ergotamine plus caffeine (P < 0.05). Almotriptan was associated with a significantly lower rate of photophobia at 90 min (P < 0.05), phonophobia at 60, 90, and 120 min (P < 0.05 to <0.01), and nausea and vomiting at 90 and 120 min (P < 0.01) compared with ergotamine plus caffeine. A significantly greater proportion of patients were more satisfied with almotriptan than with ergotamine plus caffeine (P < 0.05). Sixteen patients reported adverse events during almotriptan treatment and 27 patients reported AEs during the ergotamine plus caffeine therapy. Most AEs were mild-to-moderate and did not result in treatment-related discontinuations. In conclusion, almotriptan was associated with significantly greater efficacy for treating migraine compared with ergotamine plus caffeine, was generally well tolerated and was associated with greater rate of treatment satisfaction.
authors.affiliation: Neurology Department, Hospital Clínic Universitari, University of Valencia, Valencia, Spain. jlaineza@meditex.es
authors.forename: M J A
authors.initials: MJ
authors.lastname: Láinez
authors.forename: J
authors.initials: J
authors.lastname: Galván
authors.forename: J
authors.initials: J
authors.lastname: Heras
authors.forename: C
authors.initials: C
authors.lastname: Vila
mesh_terms: D000208:Acute Disease; D000328:Adult; D002110:Caffeine / Q000008:administration & dosage* / Q000009:adverse effects; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D004878:Ergotamine / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008881:Migraine Disorders / Q000188:drug therapy* / Q000503:physiopathology; D009325:Nausea / Q000139:chemically induced / Q000517:prevention & control; D017060:Patient Satisfaction; D010726:Phosphodiesterase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects; D020795:Photophobia / Q000139:chemically induced / Q000517:prevention & control; D017366:Serotonin Receptor Agonists / Q000008:administration & dosage / Q000009:adverse effects; D016896:Treatment Outcome; D014363:Tryptamines / Q000008:administration & dosage* / Q000009:adverse effects; D014662:Vasoconstrictor Agents / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D010726:Phosphodiesterase Inhibitors; D017366:Serotonin Receptor Agonists; D014363:Tryptamines; D014662:Vasoconstrictor Agents; C409045:almotriptan; D002110:Caffeine; D004878:Ergotamine