Allodynia-associated symptoms, pain intensity and time to treatment: predicting treatment response in acute migraine intervention.
OBJECTIVE
To evaluate the relationship between treatment outcomes and allodynia-associated symptoms (AAS) at the time of treatment with almotriptan.


METHODS
Analyses were performed with data collected prospectively from patients in 2 recently completed early intervention trials, AXERT Early miGraine Intervention Study (AEGIS) and AXERT 12.5 mg time vs Intensity Migraine Study (AIMS): 2-hour pain free, 2-hour pain relief (AEGIS only), sustained pain free (SPF), use of rescue medication, and median headache duration (AIMS only), in the presence and absence of pretreatment AAS, which was determined by responses to a questionnaire. Analyses were conducted to evaluate possible prognostic variables.


RESULTS
The presence of pretreatment AAS did not have a significant effect on 2-hour pain-free, 2-hour pain-relief or SPF rates, use of rescue medication, or headache duration. Significant factors for most favorable outcomes (greater 2-hour pain-free, 2-hour pain-relief and SPF rates, less use of rescue medication, and shorter headache duration) included treatment with almotriptan 12.5 mg, treatment of mild or moderate headache pain, and treatment within 1 hour of headache onset.


CONCLUSIONS
Almotriptan 12.5 mg was efficacious in providing 2-hour pain free, 2-hour pain relief, SPF, and reducing rescue medication use irrespective of the presence of AAS at the time of treatment. The most optimal efficacy outcomes occurred when patients treated migraine attacks early and before the onset of severe pain. The presence of AAS, which may indicate an early phase of allodynia, did not influence the efficacy of almotriptan therapy.
Cady
Roger K
RK
Headache Care Center, Springfield, MO 65807, USA.
Freitag
Frederick G
FG
Mathew
Ninan T
NT
Elkind
Arthur H
AH
Mao
Lian
L
Fisher
Alan C
AC
Biondi
David M
DM
Finlayson
Gary
G
Greenberg
Steven J
SJ
Hulihan
Joseph F
JF
D000293:Adolescent; D000328:Adult; D000368:Aged; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006941:Hyperesthesia / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000150:complications / Q000188:drug therapy*; D010147:Pain Measurement; D017288:Pain Threshold / Q000187:drug effects; D012189:Retrospective Studies; D017366:Serotonin Receptor Agonists / Q000494:pharmacology / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome; D014363:Tryptamines / Q000494:pharmacology / Q000627:therapeutic use*; D055815:Young Adult
D017366:Serotonin Receptor Agonists; D014363:Tryptamines; C409045:almotriptan