title: Treatment with telmisartan, a long-acting angiotensin II receptor blocker, prevents migraine attacks in Japanese non-responders to lomerizine.
abstract: Lomerizine, calcium channel blocker, is the most used medication for migraine prophylaxis in Japan. The effectiveness of this drug is reported as 50-75%. Telmisartan is angiotensin II receptor blockers which plasma half-life is 24 h. We examined whether telmisartan has preventative benefits in lomerizine non-responsive migraineurs. Lomerizine non-responders received telmisartan (20 mg/day) for 3 months after the investigation period of 3 months. Blood pressure, frequency of headache days/month, headache severity, and doses of triptans and analgesics were analyzed by Wilcoxon signed rank test. Thirty-three migraineurs (25 women and 8 men) participated in this study. Seven patients had migraine with aura and 26 patients had migraine without aura. Mean age (SD) was 46.6 (10.3) years. Mean duration (SD) of migraine was 20.4 (12.5) years. Headache severity exhibited mild degree in 5 patients, moderate degree in 9 patients and severe degree in 19 patients. Mean frequency (SD) of headache days was 10.9 (8.5) days/month. Mean usage (SD) of triptans was 4.8 (5.1) tablets/month and that of analgesics was 15.2 (22.2) tablets/month. Five patients (15%) had hypertension. Telmisartan administration had benefits in 30 patients (90%). This medication significantly decreased frequency of headache days (P < 0.01) and headache severity (P < 0.01). Doses of triptans were reduced at one-third (P < 0.05) and those of analgesia at one-fifth after telmisartan treatment (P < 0.01). After telmisartan, mean (SD) of systolic blood pressure was significantly decreased (P < 0.05). The present study supported that telmisartan treatment had preventive effects in 90% of lomerizine non-responders. Telmisartan non-responders (10%) exhibited chronic migraine and long migraine duration.
authors.affiliation: Department of Neurology, Toho University Omori Medical Center, 6-11-1, Omorinishi, Otaku, Tokyo, 143-8541, Japan. keni@med.toho-u.ac.jp.|Department of Neurology, PL Tokyo Heath Care Center, Tokyo, Japan. keni@med.toho-u.ac.jp.
authors.forename: Ken
authors.initials: K
authors.lastname: Ikeda
authors.affiliation: Department of Neurology, Toho University Omori Medical Center, 6-11-1, Omorinishi, Otaku, Tokyo, 143-8541, Japan.
authors.forename: Sayori
authors.initials: S
authors.lastname: Hanashiro
authors.affiliation: Department of Neurology, Toho University Omori Medical Center, 6-11-1, Omorinishi, Otaku, Tokyo, 143-8541, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Ishikawa
authors.affiliation: Department of Neurology, Toho University Omori Medical Center, 6-11-1, Omorinishi, Otaku, Tokyo, 143-8541, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Sawada
authors.affiliation: Department of Neurology, Toho University Omori Medical Center, 6-11-1, Omorinishi, Otaku, Tokyo, 143-8541, Japan.
authors.forename: Maya
authors.initials: M
authors.lastname: Kyuzen
authors.affiliation: Department of Neurology, Toho University Omori Medical Center, 6-11-1, Omorinishi, Otaku, Tokyo, 143-8541, Japan.
authors.forename: Harumi
authors.initials: H
authors.lastname: Morioka
authors.affiliation: Department of Neurology, Toho University Omori Medical Center, 6-11-1, Omorinishi, Otaku, Tokyo, 143-8541, Japan.
authors.forename: Junya
authors.initials: J
authors.lastname: Ebina
authors.affiliation: Department of Neurology, Toho University Omori Medical Center, 6-11-1, Omorinishi, Otaku, Tokyo, 143-8541, Japan.
authors.forename: Junpei
authors.initials: J
authors.lastname: Nagasawa
authors.affiliation: Department of Neurology, Toho University Omori Medical Center, 6-11-1, Omorinishi, Otaku, Tokyo, 143-8541, Japan.
authors.forename: Masaru
authors.initials: M
authors.lastname: Yanagihashi
authors.affiliation: Department of Neurology, Toho University Omori Medical Center, 6-11-1, Omorinishi, Otaku, Tokyo, 143-8541, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Miura
authors.affiliation: Department of Neurology, Toho University Omori Medical Center, 6-11-1, Omorinishi, Otaku, Tokyo, 143-8541, Japan.
authors.forename: Takehisa
authors.initials: T
authors.lastname: Hirayama
authors.affiliation: Department of Neurology, Toho University Omori Medical Center, 6-11-1, Omorinishi, Otaku, Tokyo, 143-8541, Japan.
authors.forename: Takanori
authors.initials: T
authors.lastname: Takazawa
authors.affiliation: Department of Neurology, Toho University Omori Medical Center, 6-11-1, Omorinishi, Otaku, Tokyo, 143-8541, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Kano
authors.affiliation: Department of Neurology, Toho University Omori Medical Center, 6-11-1, Omorinishi, Otaku, Tokyo, 143-8541, Japan.
authors.forename: Kiyokazu
authors.initials: K
authors.lastname: Kawabe
authors.affiliation: Department of Neurology, Toho University Omori Medical Center, 6-11-1, Omorinishi, Otaku, Tokyo, 143-8541, Japan.|Department of Neurology, PL Tokyo Heath Care Center, Tokyo, Japan.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Iwasaki
mesh_terms: D000328:Adult; D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use*; D001562:Benzimidazoles / Q000627:therapeutic use*; D001565:Benzoates / Q000627:therapeutic use*; D002121:Calcium Channel Blockers / Q000009:adverse effects; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000188:drug therapy / Q000517:prevention & control*; D010879:Piperazines / Q000009:adverse effects; D012720:Severity of Illness Index; D000077333:Telmisartan
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D001562:Benzimidazoles; D001565:Benzoates; D002121:Calcium Channel Blockers; D010879:Piperazines; C052424:lomerizine; D000077333:Telmisartan
keywords: Angiotensin II receptor blocker; Calcium channel blocker; Lomerizine; Migraine prophylaxis; Telmisartan