Long‐Term Migraine Prevention With Topiramate: Open‐Label Extension of Pivotal Trials

Rapoport, Alan M.; Mauskop, Alexander; Diener, Hans‐Christoph; Schwalen, S.; Pfeil, J.

doi:10.1111/j.1526-4610.2006.00506.x

Cited by 57 publications

(61 citation statements)

References 17 publications

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“…In this extension phase, patients had a sustained reduction in mean monthly migraine frequency, regardless of the type or dose of study medication received in the double-blind phase (topiramate or placebo). The safety of topiramate was consistent with that observed during the two 26-week pivotal trials [43].…”

Section: Pharmacokineticssupporting

confidence: 81%

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Clinical pharmacology of topiramate in migraine prevention

Ferrari

Tiraferri

Neri

et al. 2011

Expert Opinion on Drug Metabolism & Toxicology

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Topiramate is an important option for the prophylaxis of migraine and is of proven efficacy and tolerability. It has also been studied in chronic migraine with encouraging results, even in patients with medication overuse. However, in migraine prevention its efficacy is comparable to the other first-line drugs and there are no published trials with a superiority design which can establish topiramate's role in the available therapeutic armamentarium.

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Section: Pharmacokineticssupporting

confidence: 81%

“…To have a substantial effect on the evolution of migraine, benefits of prophylaxis should persist even after its withdrawal [43]. When treatment is discontinued, the frequency of migraine increases instead already in the first 4 weeks after discontinuation [67].…”

Section: Expert Opinionmentioning

confidence: 99%

Clinical pharmacology of topiramate in migraine prevention

Ferrari

Tiraferri

Neri

et al. 2011

Expert Opinion on Drug Metabolism & Toxicology

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show abstract

“…A big Open-Label Extension of Pivotal Trials, in which 403 patients completed the trial, also included patients aged 12-18 years [Rapoport et al, 2006]. These authors concluded that patients receiving topiramate experienced a sustained reduction in migraine frequency for up to 14 months (5.572.3 attacks/month at baseline versus 3.472.6 attacks/ month at the end of the 6-month double-blind phase and 2.272.4 attacks/month after an additional 8 months of open-label topiramate).…”

Section: Topiramatementioning

confidence: 99%

Antiepileptic drugs in the preventive treatment of migraine in children and adolescents

Vollono

Ferraro

Valeriani

2007

Drug Development Research

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Migraine prevalence in childhood ranges from 2.7 to 10% causing a significant impact on quality of life. No drugs are currently approved for use in the prevention of pediatric migraine. Antiepileptic drugs such as valproate and topiramate have been approved for the preventive treatment of migraine in adults. The present study aimed at reviewing evidence on the efficacy and safety of antiepileptic drugs in the preventive treatment of migraine in children and adolescents. We searched PubMed from 1988 to May 2007 and reviewed, abstracted, and classified relevant literature. Thirteen studies were reviewed. Data from randomized controlled trials are available only for valproate and topiramate. They show that both topiramate and valproate are effective in reducing headache frequency, intensity, and duration. As for safety and tolerability, topiramate is well tolerated, while there are insufficient data regarding the tolerability of valproate. Open-label or retrospective studies suggest that levetiracetam, zonisamide, and gabapentin are effective, but further evidence is warranted to confirm these data. © 2007 Wiley-Liss, Inc

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“…The minimum suggested trial to assess the benefits of prophylaxis is in fact 2-3 months [6,7,11], although many physicians prefer longer treatment periods, which can give more relevant results, as indicated by recently published trials [13,14]. After such a treatment period, the same or a different compound can be prescribed for a similar or for longer periods, taking into account the efficacy and tolerability of the first prescription as assessed at follow-up visits.…”

Section: Introductionmentioning

confidence: 99%

Controversies in migraine: monotherapy

D’Amico

2012

Neurol Sci

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Migraine patients with frequent and severe headaches need prophylaxis. The most used approach is monotherapy, i.e. one of the available preventive compounds is prescribed to the patient, testing its efficacy and tolerability during a treatment period of some months. Some clinicians use to add a second (or even a third) preventive compound to improve the effects of pharmacological prophylaxis, using an approach that can be defined as polytherapy. In this paper, the main advantages of monotherapy are briefly reviewed, taking into account several aspects: published evidence on polytherapy; the possibility to evaluate the adverse events of the prescribed treatment and to assess its real efficacy; the possibility of addressing different patient's needs, particularly the treatment of comorbidities and the development of an effective patient-physician communication.

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Long‐Term Migraine Prevention With Topiramate: Open‐Label Extension of Pivotal Trials

Abstract: Patients receiving topiramate experienced a sustained reduction in migraine frequency for up to 14 months. The effectiveness and safety of topiramate was consistent with that observed during 2 26-week pivotal trials.

Cited by 57 publications

References 17 publications

Clinical pharmacology of topiramate in migraine prevention

Clinical pharmacology of topiramate in migraine prevention

Antiepileptic drugs in the preventive treatment of migraine in children and adolescents

Controversies in migraine: monotherapy

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