Clinical aspects of perimenstrual headaches

Taylor, Frederick R.

doi:10.1007/s11916-009-0015-z

Cited by 3 publications

(5 citation statements)

References 27 publications

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“…These headache attacks are reported to be particularly severe, more disabling, more difficult to manage, and need immediate acute or preventive treatment with a drug capable of ensuring a sustained effect [3]. …”

Section: Introductionmentioning

confidence: 99%

Efficacy of frovatriptan versus other triptans in the acute treatment of menstrual migraine: pooled analysis of three double-blind, randomized, crossover, multicenter studies

et al. 2012

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The objective of this study was to review the efficacy and safety of frovatriptan (F) versus rizatriptan (R), zolmitriptan (Z) and almotriptan (A), in women with menstrually related migraine (IHS criteria) through a pooled analysis of three individual studies. Subjects with a history of migraine with or without aura were randomized to F 2.5 mg or R 10 mg (study 1), F or Z 2.5 mg (study 2), and F or A 12.5 mg (study 3). The studies had an identical multicenter, randomized, double-blind, crossover design. After treating three episodes of migraine in no more than 3 months with the first treatment, patients had to switch to the next treatment for other 3 months. 346 subjects formed intention-to-treat population of the main study; 280 of them were of a female gender, 256 had regular menses and 187 were included in the menstrual migraine subgroup analysis. Rate of pain free at 2, 4 and 24 h was 23, 52 and 67 % with F and 30, 61 and 66 % with comparators (P = NS). Pain relief episodes at 2, 4 and 24 h were 37, 60 and 66 % for F and 43, 55 and 61 % for comparators (P = NS). Rate of recurrence was significantly (P \ 0.05) lower under F either at 24 h (11 vs. 24 % comparators) or at 48 h (15 vs. 26 % comparators). Number of menstrual migraine attacks associated with drug-related adverse events was equally low (P = NS) between F (5 %) and comparators (4 %).

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Section: Introductionmentioning

confidence: 99%

Efficacy of frovatriptan versus other triptans in the acute treatment of menstrual migraine: pooled analysis of three double-blind, randomized, crossover, multicenter studies

et al. 2012

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“…Triptans are recommended as first-line treatment for moderate to severe migraine, hence including MM [Taylor, 2009; Mannix and Files, 2005].…”

Section: Use Of Triptans In MMmentioning

confidence: 99%

“…Menstruation is usually defined by endometrial bleeding resulting from either the normal menstrual cycle, or from the withdrawal of exogenous progestogens, as in the case of combined oral contraceptives and cyclical hormone replacement therapy. Migraine attacks occur exclusively around the menstrual period in approximately 10% of women, that is, pure menstrual migraine (PMM), while at least half of women with migraine experience MRM [MacGregor, 2008; Martin and Lipton, 2008; Taylor, 2009].…”

Section: Introductionmentioning

confidence: 99%

A review of the use of frovatriptan in the treatment of menstrually related migraine

Allais

Benedetto

2012

Ther Adv Neurol Disord

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Current therapeutic approach to MMThe therapeutic approach to patients with MRM is based on treatment of the symptoms of attack, or with prophylactic strategies [Silberstein et al. 2012;Steiner et al. 2007].A review of the use of frovatriptan in the treatment of menstrually related migraine Gianni Allais and Chiara Benedetto Abstract: Menstrual migraine (MM) is a highly prevalent condition associated with considerable disability. Migraine attacks occur exclusively around the menstrual period in approximately 10% of women with migraine, that is, pure menstrual migraine, while at least 50% of them also experience migraine at other times of the month, that is, menstrually related migraine (MRM). The therapeutic approach to patients with MRM is based on treatment of the attack, or prophylactic strategies. Triptans are recommended as first-line treatments for moderate to severe migraine attacks, including MM. Frovatriptan is one of the newest triptans. Its high affinity for 5-HT 1B/1D receptors and long half-life contribute to its distinctive clinical effect, characterized by a more sustained and prolonged effect than other triptans. Indeed, frovatriptan proved to be effective in treating the acute attack, but was particularly effective in the short-term preventive therapy of MM. In addition, frovatriptan is one of the safest triptans, with the lowest risk of treatment-emergent adverse events. Following extensive evidence from randomized pharmacological trials, frovatriptan has now gained a grade A recommendation from the guidelines for short-term prophylaxis of MM. Recent post-hoc analyses of direct comparative trials also suggest that frovatriptan might have an important role in the acute treatment of MRM. In these studies, frovatriptan showed pain relief and pain-free rates similar to those of zolmitriptan, rizatriptan, and almotriptan, but with significantly lower recurrence rates. More well-designed, randomized, prospective studies, specifically enrolling women with MM, will be needed in the near future to confirm the efficacy of frovatriptan in this migraine subtype.

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“…Female migraineurs frequently experience headaches in association with their menstrual cycles [1, 2]. These migraine attacks represent a challenge for both the patient and the headache specialist as they have been shown to be particularly difficult to treat and more disabling than migraines outside of the menstrual period [3].…”

Section: Introductionmentioning

confidence: 99%

“…Triptans are a recommended first-line treatment for moderate to severe migraine, including menstrual migraine [2, 4]. Sumatriptan, the first triptan to be marketed, has been shown to be well tolerated and effective in providing pain relief in menstrual migraine when administered in the mild pain phase, and also when used in combination with analgesics [5–11].…”

Section: Introductionmentioning

confidence: 99%

Frovatriptan versus almotriptan for acute treatment of menstrual migraine: analysis of a double-blind, randomized, cross-over, multicenter, Italian, comparative study

et al. 2012

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The objective of the study was to compare the efficacy and safety of frovatriptan and almotriptan in women with menstrually related migraine (IHS Classification of Headache disorders) enrolled in a multicenter, randomized, double-blind, cross-over study. Patients received frovatriptan 2.5 mg or almotriptan 12.5 mg in a randomized sequence: after treating 3 episodes of migraine in no more than 3 months with the first treatment, the patient was switched to the other treatment. 67 of the 96 female patients of the intention-to-treat population of the main study had regular menstrual cycles and were thus included in this subgroup analysis. 77 migraine attacks classified as related to menses were treated with frovatriptan and 78 with almotriptan. Rate of pain relief at 2 and 4 h was 36 and 53 % for frovatriptan and 41 and 50 % for almotriptan (p = NS between treatments). Rate of pain free at 2 and 4 h was 19 and 47 % with frovatriptan and 29 and 54 % for almotriptan (p = NS). At 24 h, 62 % of frovatriptan-treated and 67 % of almotriptan-treated patients had pain relief, while 60 versus 67 % were pain free (p = NS). Recurrence at 24 h was significantly (p < 0.05) lower with frovatriptan (8 vs. 21 % almotriptan). This was the case also at 48 h (9 vs. 24 %, p < 0.05). Frovatriptan was as effective as almotriptan in the immediate treatment of menstrually related migraine attacks. However, it showed a more favorable sustained effect, as shown by a lower rate of migraine recurrence.

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Clinical aspects of perimenstrual headaches

Cited by 3 publications

References 27 publications

Efficacy of frovatriptan versus other triptans in the acute treatment of menstrual migraine: pooled analysis of three double-blind, randomized, crossover, multicenter studies

Efficacy of frovatriptan versus other triptans in the acute treatment of menstrual migraine: pooled analysis of three double-blind, randomized, crossover, multicenter studies

A review of the use of frovatriptan in the treatment of menstrually related migraine

Frovatriptan versus almotriptan for acute treatment of menstrual migraine: analysis of a double-blind, randomized, cross-over, multicenter, Italian, comparative study

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