Multimechanistic (sumatriptan-naproxen) early intervention for the acute treatment of migraine

Silberstein, Stephen D.; Mannix, Lisa K.; Goldstein, Jerome; Couch, J. R.; Byrd, S. C.; Ames, Michael; McDonald, Susan A.; Lener, Shelly E.

doi:10.1212/01.wnl.0000316800.22949.20

Cited by 50 publications

(38 citation statements)

References 34 publications

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“…Although significantly fewer female participants treating with sumatriptan-naproxen used rescue medication compared with placebo in this study, the overall incidence of rescue medication was higher than that reported previously in early intervention studies that included both men and women. 12,13 Although the majority of participants in the current studies attributed their use of rescue medication to "migraine," the coexistence of menstrual pain may influence the use of pain medication.…”

Section: Discussionmentioning

confidence: 90%

Combination Treatment for Menstrual Migraine and Dysmenorrhea Using Sumatriptan–Naproxen

Mannix¹,

Martin²,

Cady³

et al. 2009

Obstetrics &Amp; Gynecology

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Section: Discussionmentioning

confidence: 90%

Combination Treatment for Menstrual Migraine and Dysmenorrhea Using Sumatriptan–Naproxen

Mannix¹,

Martin²,

Cady³

et al. 2009

Obstetrics &Amp; Gynecology

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“…Pain-free efficacy of migraine pharmacotherapy appears to be enhanced, and the incidence of adverse events appears to be reduced by the practice of early intervention [Goadsby et al 2008;Silberstein et al 2008;Mathew et al 2007;Carpay et al 2004;Brandes et al 2005;Loder et al 2005;Mathew et al 2004;Scholpp et al 2004;Cady et al 2000]. These caveats notwithstanding, the results demonstrate the better performance of sumatriptan/naproxen sodium to sumatriptan monotherapy, naproxen sodium monotherapy and placebo with respect to the rigorous clinical endpoint of sustained pain-free/no adverse events and reinforce the usefulness of utilizing this new composite endpoint.…”

Section: Discussionmentioning

confidence: 67%

Fixed-dose sumatriptan/naproxen sodium compared with each monotherapy utilizing the novel composite endpoint of sustained pain-free/no adverse events

Landy¹,

White

Lener

et al. 2009

Ther Adv Neurol Disord

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A novel composite endpoint, sustained pain-free/no adverse events, was recently proposed as a more rigorous means of capturing in a single measure the attributes of migraine pharmacotherapy that patients consider most important: rapid and sustained pain-free response with no side-effects. Using pooled data from two replicate randomized, double-blind, parallel-group, placebo-controlled studies, this post hoc analysis compared the fixed-dose combination tablet sumatriptan/naproxen sodium (n ¼ 726) with sumatriptan monotherapy (n ¼ 723), naproxen sodium monotherapy (n ¼ 720), and placebo (n ¼ 742) with respect to sustained pain-free/no adverse events and closely related composite measures. Sustained painfree/no adverse events was defined as having both a sustained pain-free response from 2 through 24 hours post-dose with no use of rescue medication and having no adverse events within up to 5 days after dosing with study medication. The percentage of patients with sustained pain-free/no adverse events was 16% with sumatriptan/naproxen sodium compared with 11%, 9% and 7% for sumatriptan, naproxen sodium and placebo, respectively (p50.01 sumatriptan/naproxen sodium versus each other treatment). Sumatriptan/naproxen sodium was also significantly more effective than sumatriptan, naproxen sodium, and placebo for other composite endpoints including the percentages of patients with (1) sustained pain-free/no adverse events within 1 day; (2) sustained pain-free/no drug-related adverse events within up to 5 days; (3) sustained pain-free/no drug-related adverse events within 1 day; (4) sustained pain relief/no adverse events within up to 5 days; and (5) sustained pain relief/no adverse events within 1 day. The results demonstrate the superiority of sumatriptan/naproxen sodium to sumatriptan monotherapy, naproxen sodium monotherapy and placebo with respect to the rigorous and clinically relevant endpoint of sustained pain-free/no adverse events and reinforce the usefulness of utilizing this new composite endpoint.

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“…The combination was more effective than either sumatriptan 85 mg or naproxen 500 mg alone [83,84]. Interestingly, sumatriptan 85mg was not superior to naproxen 500 mg.…”

Section: Combination Therapy Strategiesmentioning

confidence: 90%

“…At 2 h, 52 and 51% of sumatriptan/naproxen-treated patients were pain free, as compared with 17% and 15% of placebo-treated patients (p < 0.001) [84].…”

Section: Treatment Of Mild Versus Moderate-to-severe Intervention Strmentioning

confidence: 90%

The triptans

Bigal¹,

Krymchantowski²,

Hargreaves³

2009

Expert Review of Neurotherapeutics

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The migraine-specific triptans have revolutionized the treatment of migraine and are currently the drugs of choice to treat a migraine attack in progress. Over the past 15 years, triptans were released in rapid succession, with each one demonstrating some specific pharmacokinetic properties that may be translated into clinical advantages. Triptans share many similarities, but also have important differences from one another. Accordingly, herein we discuss the class of the triptans. We first define the trigeminovascular system and its importance in migraine pain, then discuss the mechanism of action of the triptans and contrast the evidence supporting the use of different triptans. We close with our view of the future and hopes for the next generation of antimigraine therapies.

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Multimechanistic (sumatriptan-naproxen) early intervention for the acute treatment of migraine

Abstract: The fixed-dose single-tablet formulation of sumatriptan/naproxen was effective and well tolerated in an early intervention paradigm for the acute treatment of migraine, including traditional and nontraditional symptoms.

Cited by 50 publications

References 34 publications

Combination Treatment for Menstrual Migraine and Dysmenorrhea Using Sumatriptan–Naproxen

Combination Treatment for Menstrual Migraine and Dysmenorrhea Using Sumatriptan–Naproxen

Fixed-dose sumatriptan/naproxen sodium compared with each monotherapy utilizing the novel composite endpoint of sustained pain-free/no adverse events

The triptans

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