Frovatriptan plus dexketoprofen in the treatment of menstrually related migraine: an open study

Abstract

At least 50 % of female migraineurs experience migraine associated with the perimenstrual period, even though they may also suffer from attacks at other times of the cycle (menstrually related migraine, MRM). MRM attacks tend to be longer and more intense than those arising in other phases of the menstrual cycle, and are often aggravated by more pronounced vegetative phenomena. In this open preliminary trial, we tested the efficacy of associating frovatriptan and dexketoprofen for the treatment of an acute attack of MRM, diagnosed according to the criteria of the International Headache Society, in 24 patients between 19 and 45 years of age (mean 31.33 ± 7.33). Twenty-one of them completed the study. Pain relief was achieved by 76 % of patients at 2 h and by 86 % at 4 h. A pain-free state was achieved by 48 % at 2 h and by 62 % at 4 h from taking the product. A pain-free state at 24 h was present in 76 % of MRM sufferers, 33 % of whom showed a sustained pain-free state at 24 h. A rescue medication was needed by eight patients. While decidedly encouraging, the data of this study obviously need confirmation with double blind studies involving a greater number of patients.

Systematic Review of Preventive and Acute Treatment of Menstrual Migraine

“…13 Headache recurrence at 24 hours was 29.1% in the zolmitriptan group vs 45.1% in the placebo group (P 5 .0009). 14,15 The first study by Bigal et al was a randomized, double-blind crossover trial that assessed efficacy of rizatriptan, dexamethasone, or a combination of both. 14,15 The first study by Bigal et al was a randomized, double-blind crossover trial that assessed efficacy of rizatriptan, dexamethasone, or a combination of both.…”

“…14 The second study by Allais was an open label study that tested efficacy of frovatriptan and dexketoprofen for treatment of acute attack of menstrual migraine. 15 There were no data reporting statistical significance and the study was open label, which can lead to reporting bias. Rizatriptan 1 dexamethasone was superior to rizatriptan (81.5% vs 62.7%, P < .05) and to dexamethasone (81.5% vs 33.3%, P < .001).…”

“…13 Combined Therapy.-Two articles included for review assessed the efficacy of a triptan in combination with a second agent. 14,15 The first study by Bigal et al was a randomized, double-blind crossover trial that assessed efficacy of rizatriptan, dexamethasone, or a combination of both. 14 The second study by Allais was an open label study that tested efficacy of frovatriptan and dexketoprofen for treatment of acute attack of menstrual migraine.…”

“…A pain-free state at 24 hours was present in 76% of menstrually related migraine sufferers, 33% of whom showed a sustained pain-free state at 24 hours. 15 There were no data reporting statistical significance and the study was open label, which can lead to reporting bias. Prostaglandin Synthesis Inhibitor.-A randomized double-blind, placebo controlled trial of mefenamic acid evaluated its efficacy in pain relief.…”

A review of frovatriptan for the treatment of menstrual migraine

“…Head-to-head studies do not show superiority of one triptan over any other 37. There is some evidence to recommend a combination of a triptan and an NSAID 38,39. In all cases, treatment should be tailored, taking into account individual preferences, comorbidities, and risk of adverse events (AEs).…”