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- Title
Triptans (serotonin, 5-HT<sub>1B/1D</sub> agonists) in migraine: detailed results and methods of a meta-analysis of 53 trials.
- Authors
Ferrari, MD; Goadsby, PJ; Roon, KI; Lipton, RB
- Abstract
The triptans, selective serotonin 5-HT1B/1D agonists, are very effective acute migraine drugs. Soon, seven different triptans will be clinically available at 13 different oral doses, making evidence-based selection guidelines necessary. Triptan trials have similar designs, facilitating meta-analysis. We wished to provide an evidence-based foundation for using triptans in clinical practice, and to review the methodological issues surrounding triptan trials. We asked pharmaceutical companies and the principal investigators of company-independent trials for the ‘raw patient data’ of all double-blind, randomized, controlled, clinical trials with oral triptans in migraine. All data were cross-checked with published or presented data. We calculated summary estimates across studies for important efficacy and tolerability parameters, and compared these with those from direct, head-to-head, comparator trials. Out of 76 eligible clinical trials, 53 (12 not yet published) involving 24 089 patients met the criteria for inclusion. Mean results (and 95% confidence intervals) for sumatriptan 100 mg, the first available and most widely prescribed oral triptan, are 59% (57–60) for 2 h headache response (improvement from moderate or severe to mild or no pain); 29% (27–30) for 2 h pain free (improvement to no pain); 20% (18–21) for sustained pain free (pain free by 2 h and no headache recurrence or use of rescue medication 2–24 h post-dose), and 67% (63–70) for consistency (response in at least two out of three treated attacks); placebo-subtracted proportions for patients with at least one adverse event (AE) are 13% (8–18), for at least one central nervous system AE 6% (3–9), and for at least one chest AE 1.9% (1.0–2.7). Compared with these data: rizatriptan 10 mg shows better efficacy and consistency, and similar tolerability; eletriptan 80 mg shows better efficacy, similar consistency, but...
- Publication
Cephalalgia, 2002, Vol 22, Issue 8, p633
- ISSN
0333-1024
- Publication type
Academic Journal
- DOI
10.1046/j.1468-2982.2002.00404.x