title: Outcome for headache and pain-free nonresponders to treatment of the first attack: a pooled post-hoc analysis of four randomized trials of eletriptan 40 mg.
abstract: OBJECTIVE
  The objective of this article is to evaluate, in first attack eletriptan headache and pain-free nonresponders, the efficacy of treating a second and third attack with the same dose of eletriptan 40 mg (ELE-40).
  
  
  METHODS
  Data were pooled from four randomized, double-blind, placebo-controlled, multiple attack studies of eletriptan in the treatment of migraine. The first-attack eletriptan headache (HNR) and pain-free (PFNR) nonresponder samples consisted of patients who did not achieve headache or pain-free responses at two hours, or sustained headache or pain-free responses at 24 hours. The efficacy of the same dose of eletriptan (vs placebo; PBO) in treating the second and third attacks was evaluated using a logistic regression model.
  
  
  RESULTS
  Among Attack 1 eletriptan HNRs, treatment with ELE-40 (vs PBO) was associated with significantly higher two-hour headache response and pain-free rates, respectively, on both Attack 2 (48.8% vs 20.2%; 17.0% vs 3.9%; P  < 0.0001 for both comparisons) and Attack 3 (37.4% vs 15.5%; 18.8% vs 3.2%; P  < 0.0001 for both comparisons). Significantly higher sustained headache response and pain-free rates at 24 hours were also observed on both Attack 2 and Attack 3.
  
  
  CONCLUSIONS
  The results of this pooled analysis suggest that patients who have HNR or PFNR to an initial dose of eletriptan may respond when a second and third attack is treated with the same dose.
authors.affiliation: Wesley Neurology Clinic, TN, USA.
authors.forename: Steve H
authors.initials: SH
authors.lastname: Landy
authors.forename: Stewart J
authors.initials: SJ
authors.lastname: Tepper
authors.forename: Edward
authors.initials: E
authors.lastname: Schweizer
authors.forename: Mary
authors.initials: M
authors.lastname: Almas
authors.forename: Elodie
authors.initials: E
authors.lastname: Ramos
mesh_terms: D004311:Double-Blind Method; D006801:Humans; D008881:Migraine Disorders / Q000188:drug therapy*; D011759:Pyrrolidines / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D017366:Serotonin Receptor Agonists / Q000627:therapeutic use*; D016896:Treatment Outcome; D014363:Tryptamines / Q000627:therapeutic use*
chemical_list: D011759:Pyrrolidines; D017366:Serotonin Receptor Agonists; D014363:Tryptamines; C115647:eletriptan
keywords: Migraine; eletriptan; nonresponse; triptan