Efficacy of frovatriptan in the acute treatment of menstrually related migraine: analysis of a double-blind, randomized, multicenter, Italian, comparative study versus zolmitriptan

Abstract

Menstrually related migraine (MRM) is a particularly difficult-to-treat pain condition, associated with substantial disability. Aim of this study was to compare the efficacy and safety of frovatriptan and zolmitriptan in the treatment of MRM attacks, analyzing data from a multicenter, randomized, double blind, cross-over study. We analyzed the subset of 76 regularly menstruating women who participated in one head-to-head multicenter, randomized, double blind, cross-over clinical trial and who took the study drugs to treat MRM attacks. In a randomized sequence, each patient received frovatriptan 2.5 mg or zolmitriptan 2.5 mg: after treating three episodes of migraine in no more than 3 months with the first treatment, the patient had to switch to the other treatment. MRM was defined according to the criteria listed in the Appendix of the last Classification of Headache disorders of the International Headache Society. A total of 73 attacks, classified as MRM, were treated with frovatriptan and 65 with zolmitriptan. Rate of pain relief at 2 h was 52% for frovatriptan and 53% for zolmitriptan (p = NS), while rate of pain free at 2 h was 22 and 26% (p = NS), respectively. At 24 h, 74 and 83% of frovatriptan-treated and 69 and 82% of zolmitriptan-treated patients were pain free and had pain relief, respectively (p = NS). Recurrence at 24 h was significantly (p < 0.05) lower with frovatriptan (15 vs. 22% zolmitriptan). Frovatriptan proved to be effective in the immediate treatment of MRM attacks, similarly to zolmitriptan, but showed lower recurrence rates, and thus a better sustained relief.

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

“…In previous publications, frovatriptan showed pain-relief and pain-free rates at 2 and 24 h similar to those of rizatriptan and zolmitriptan, but significantly lower rates of recurrences at 24 h (15 vs. 22 % zolmitriptan and 10 vs. 32 % rizatriptan) [35, 36]. In another head-to-head double-blind, randomized trial comparing almotriptan with zolmitriptan, no significant differences between the two treatments were found, with similar pain-relief rates at 2 h (68 vs. 69 %), similar pain-free rates at 2 h (45 vs. 41 %) and similar recurrences at 2–24 h (33 vs. 35 %) [13].…”

“…In two recently published retrospective analyses of randomized, double-blind, cross-over, head-to-head trials, frovatriptan provided a more sustained pain relief than zolmitriptan and rizatriptan, with similar pain-free and pain-relief rates at 2 h [35, 36]. …”

Efficacy of Frovatriptan vs. Other Triptans in Weekend Migraine: Pooled Analysis of Three Double-Blind, Randomized, Crossover, Multicenter Studies

“…The study results showed a similar efficacy of the four triptans in the early treatment (within 2 hours) of migraine, but a lower rate of relapse, and thus a better sustained relief, with frovatriptan. Retrospective analyses of the same studies demonstrated the good efficacy profile of frovatriptan also in other subtypes of migraine, such as menstrually related migraine [19][20][21][22] and migraine with aura [23].…”

Frovatriptan and Rizatriptan Economic EVAluation: the FREEVA study

“…Frovatriptan is the newest addition to the triptan class: its mean half-life is 26 h, the longest in the triptan group. The molecule was selected for development based upon its distinctive pharmacologic characteristics, which suggested that it would have the clinical potential for a long duration of action [ 3 - 5 ], and a low likelihood of side effects [ 6 , 7 ] and drug interactions [ 3 , 4 , 8 , 9 ]. This therapeutic profile makes this triptan particularly suitable for treating patients whose migraine attacks last a long time, with an associated high risk of headache recurrence.…”