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A double-blind, randomized, multicenter, Italian study of frovatriptan versus almotriptan for the acute treatment of migraine

A double-blind, randomized, multicenter, Italian study of frovatriptan versus almotriptan for the acute treatment of migraine,10.1007/s10194-011-0325-

A double-blind, randomized, multicenter, Italian study of frovatriptan versus almotriptan for the acute treatment of migraine   (Citations: 2)
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Marco BartoliniMaria, Maria Adele Giamberardino, Carlo Lisotto, Paolo Martelletti, Davide Moscato, Biagio Panascia, Lidia Savi, Luigi Alberto Pini, Grazia Sances, Patrizia Santoro, Giorgio Zanchin, Stefano Ombonihttp://academic.research.microsoft.com/io.ashx?type=5&id=48493237&selfId1=0&selfId2=0&maxNumber=12&query=
The objective of this study was to evaluate patients’ satisfaction with acute treatment of migraine with frovatriptan or almotriptan by preference questionnaire. One hundred and thirty three subjects with a history of migraine with or without aura (IHS 2004 criteria), with at least one migraine attack in the preceding 6 months, were enrolled and randomized to frovatriptan 2.5 mg or almotriptan 12.5 mg, treating 1–3 attacks. The study had a multicenter, randomized, double blind, cross-over design, with treatment periods lasting <3 months. At study end patients assigned preference to one of the treatments using a questionnaire with a score from 0 to 5 (primary endpoint). Secondary endpoints were pain free and pain relief episodes at 2 and 4 h, and recurrent and sustained pain free episodes within 48 h. Of the 133 patients (86%, intention-to-treat population) 114 of them expressed a preference for a triptan. The average preference score was not significantly different between frovatriptan (3.1 ± 1.3) and almotriptan (3.4 ± 1.3). The rates of pain free (30% frovatriptan vs. 32% almotriptan) and pain relief (54% vs. 56%) episodes at 2 h did not significantly differ between treatments. This was the case also at 4 h (pain free: 56% vs. 59%; pain relief: 75% vs. 72%). Recurrent episodes were significantly (P < 0.05) less frequent under frovatriptan (30% vs. 44%), also for the attacks treated within 30 min. No significant differences were observed in sustained pain free episodes (21% vs. 18%). The tolerability profile was similar between the two drugs. In conclusion, our study suggests that frovatriptan has a similar efficacy of almotriptan in the short-term, while some advantages are observed during long-term treatment.
Journal: Journal of Headache and Pain - J HEADACHE PAIN , vol. 12, no. 3, pp. 361-368, 2011
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    • ...In two cross-over randomized controlled trials (RCTs) published in the Journal of Headache and Pain, frovatriptan 2.5 mg had a similar efficacy to that of rizatriptan 10 mg [1] and almotriptan 12.5 mg [2]...
    • ...In both RCTs preference, the primary efficacy measure was quite comparable as were pain free and headache relief after 2 h, and sustained pain free for 2‐48 h [1, 2]. In contrast, in a systematic review of triptans [3n] the mean therapeutic gain (active minus placebo) for headache relief at 2 h was 19% (95% CI 16‐22%) for frovatriptan 2.5 mg, whereas it was 33% (95% CI 31‐35%) for sumatriptan 100 mg, 34% (95% CI 30‐37%) for zolmitriptan ...
    • ...Migraine patients in these RCTs [3, 4, 6] waited until the headache was moderate or severe whereas patients in the cross-over RCT were instructed to treat the migraine attack as early as possible [1, 2]. Data on headache severity at the time of treatment were not reported in the papers on these two RCTs [1, 2]; a peculiar omission in papers on acute migraine RCTs...
    • ...Migraine patients in these RCTs [3, 4, 6] waited until the headache was moderate or severe whereas patients in the cross-over RCT were instructed to treat the migraine attack as early as possible [1, 2]. Data on headache severity at the time of treatment were not reported in the papers on these two RCTs [1, 2]; a peculiar omission in papers on acute migraine RCTs...
    • ...The most likely reason for the comparable efficacy of frovatriptan and zolmitriptan [7], rizatriptan [1] and almotriptan [2 ]i n these cross-over RCTs is, however, the very early use of test treatment...

    Peer Carsten Tfelt-Hansen. When to use frovatriptan in migraine?

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