Pirprofen in the Treatment of Migraine and Episodic Headache Attacks: A Placebo-Controlled Crossover Clinical Trial

Abstract

A double-blind, within patient, randomized study to compare the efficacy and tolerability of acute rectal administration of 600 mg pirprofen capsules with matched placebo was carried out in 40 out-patients. They were divided into two groups of 20 patients each according to diagnosis of episodic headache or common or classic migraine. Treatment was given once during each of two consecutive attacks according to a crossover design. None of the patients was withdrawn after randomization. There was a statistically significant difference in favour of pirprofen as regards the preferences expressed by patients at the end of the trial: 34 patients preferred pirprofen, two preferred placebo and four patients had no preference. Pirprofen significantly reduced the duration of headache attack and associated symptoms, but not the peak of pain intensity. Tolerability of the drug was good.

Evidence for efficacy of acute treatment of episodic tension-type headache: Methodological critique of randomised trials for oral treatments

“…1): they were in chronic TTH [3,28]; 84% of patients had migraine [14]; rectal administration [26]; duplicate publication [38,80]; not randomised and double-blind [5,54,70]; without initial pain of at least moderate intensity, which can reduce sensitivity [12,13,15,16,33,65]; or not full publications [1]. Copies of 2 other publications (45 patients in total) could not be obtained [58,71].…”

Analgesics and Antipyretics, 2. Nonsteroidal Anti‐inflammatory Drugs

“…Pirprofen [31793-07-4], rac-3-chloro-4-(2,5-dihydro-1H-pyrrol-1-yl)-a-methylbenzeneacetic acid, rac-3-chloro-4-(3-pyrrolin-1-yl) hydratropic acid, C 13 Clinical use: Pirprofen is a nonsteroidal antiinflammatory drug [181] and can be used for the treatment of post-operative pain, oncological pain, episodic headache attacks, and acute migraine [182]. There are reports on hepatic and renal intolerability [183][184][185][186] C. Synthesis: The condensation of 3-hydroxyacetophenone with bromobenzene yields 3-phenoxyacetophenone, which is reduced with sodium borohydride to 1-(3-phenoxyphenyl)ethanol.…”

Expert Opinion: Rescue Me: Rescue Medication for Migraine

“…Other NSAIDs that have been shown to be effective for migraine in randomized, placebo-controlled studies include tolfenamic acid, naproxen, ibuprofen, diclofenac, pirprofen, flurbiprofen, ketoprofen, and piroxicam. [11][12][13][14][15][16][17][18] Although no placebo-controlled studies have been performed, ketorolac is used frequently in both the intramuscular and intravenous route for the acute treatment of migraine. A small study of patients self-administering injections of ketorolac found a significant improvement in their headaches, and intravenous ketorolac was superior to 20 mg nasal sumatriptan in another study.…”

“…Other NSAIDs that have been shown to be effective for migraine in randomized, placebo‐controlled studies include tolfenamic acid, naproxen, ibuprofen, diclofenac, pirprofen, flurbiprofen, ketoprofen, and piroxicam 11‐18 . Although no placebo‐controlled studies have been performed, ketorolac is used frequently in both the intramuscular and intravenous route for the acute treatment of migraine.…”