Progress in Clinical Neurosciences A Systematic Review of the Use of Triptans in Acute Migraine

Gawel, Marek; Worthington, Irene; Maggisano, Anne

doi:10.1017/s0317167100052525

Cited by 51 publications

(51 citation statements)

References 57 publications

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“…A third metanalysis performed in Canada in 2001, including the available triptans at that time in Canada (sumatriptan, rizatriptan, zolmitriptan, and naratriptan) also calculated the NNT [Gawel et al, 2001] and showed similar results to the first two metanalysis. Finally, Ferrari et al published a metanalysis that included 53 clinical trials (12 unpublished) involving 24,089 patients [Ferrari et al, 2001].…”

Section: Selecting a Triptanmentioning

confidence: 70%

Treatment of migraine in the emergency department

Hunter

Téllez‐Zenteno

2007

Drug Development Research

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Migraine is defined as a severe, episodic, unilateral, throbbing headache accompanied by nausea, photophobia, visual symptoms, and neurological manifestations. The goal of acute migraine treatment is to ensure a prompt cessation of pain and associated symptoms and resumption of normal activity. Additional considerations include minimizing adverse effects and cost of therapy. As for all neurological patients, a careful history is the first and most critical step in diagnosis and management. For many years, NSAIDs and dihydroergotamine were the main medications used to treat migraine in the emergency setting. In 1993, sumatriptan was introduced as an effective medication to treat migraine. Since then a generation of medications mechanistically similar to sumatriptan have been introduced that show notable benefits in the treatment of migraine. Over the years, other treatments have been introduced including dexamethasone, magnesium, and metoclopramide. In this article, we review the best evidence regarding the acute treatment of migraine, describing major advances and the conventional drugs that remain as effective treatments. Drug Dev Res 68: 360-368, 2007.

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Section: Selecting a Triptanmentioning

confidence: 70%

Treatment of migraine in the emergency department

Hunter

Téllez‐Zenteno

2007

Drug Development Research

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“…High responses to placebo are present in trials on treatment with triptans; on adults, trials on triptans record a response to placebo (combined data) ranging from 18% to 35% [31]. Trials on triptans showed a higher placebo effect in children and adolescents than in adults: in children, the response to placebo ranges from 14% to 40% and in adolescents from 25% to 61%.…”

Section: Placebo and Headachementioning

confidence: 99%

The effect of placebo and neurophysiological involvements

2004

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Placebo and placebo effect are important issues related to the drug therapy for clinical and scientific meanings. The rates of placebo may get as many as 50% for analgesic drugs in headache. The high answer to placebo brings questions on pathophysiology of headache. Answers may offer a new strategy in the implementation of trials and new insight in neurophysiology of headache. Current knowledge on placebo and placebo effect will be analysed and dicussed looking for new direction in headache field.

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“…Within recent years several systematic reviews with metaanalyses of acute migraine treatment have been published [18,19,36,[48][49][50][51][52][53][54]. In addition, three systematic reviews of preventive migraine treatment have been published [48,[55][56][57].…”

Section: Understanding Meta-analysesmentioning

confidence: 99%

“…In addition, three systematic reviews of preventive migraine treatment have been published [48,[55][56][57]. One should distinguish between systematic reviews, where several RCTs of a single drug are evaluated by meta-analysis to get a more precise impression of its merits [49,52,53], and systematic reviews, where several drugs or administration forms of a drug are compared in a meta-analysis [19,36,48,50,52,54].…”

Section: Understanding Meta-analysesmentioning

confidence: 99%

Understanding clinical trials in migraine

Tfelt‐Hansen

2006

J Headache Pain

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The following points are covered in this review.(1) How a randomised clinical trial in migraine is performed. The whole process from idea to publication of an article is reviewed. (2) How to understand a paper on clinical trials in migraine. The aim of the study, design of study, efficacy measures and presentation of results are reviewed. The aim of the study is often stated vaguely and it is suggested to look at the power calculations in order to understand the aim of the study. The aims and the results of the trial programmes of the triptans are reviewed. Results of the study should be presented with 95%CI. (3) How to understand meta-analyses in migraine. Relationship between meta-analyses and head-to-head comparative trials is reviewed; and it is concluded that head-to-head comparisons remain the "golden standard" with metaanalyses as a useful supplement.

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Progress in Clinical Neurosciences A Systematic Review of the Use of Triptans in Acute Migraine

Cited by 51 publications

References 57 publications

Treatment of migraine in the emergency department

Treatment of migraine in the emergency department

The effect of placebo and neurophysiological involvements

Understanding clinical trials in migraine

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