Pain-free rates with zolmitriptan 2.5 mg ODT in the acute treatment of migraine: results of a large double-blind placebo- controlled trial

Authors: Loder, Elizabeth1; Freitag, Frederick G.2; Adelman, James3; Pearlmand, Starr4; Abu-Shakra, Susan5

Source: Current Medical Research and Opinion, Volume 21, Number 3, March 2005 , pp. 381-390(10)

Publisher: Informa Healthcare

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Abstract:

Context: Zolmitriptan 2.5 mg orally disintegrating tablets (ODT) allow patients to take the medication without fluids, which is convenient and avoids the risk of fluid-induced exacerbation of nausea/vomiting.

Objective: To evaluate the efficacy and tolerability of zolmitriptan 2.5 mg ODT taken as soon as possible after onset of a migraine.

Design: Multicenter, double-blind, parallel-group, placebo-controlled two-attack trial.

Setting: Outpatient headache clinics in the US.

Patients: 608 patients were randomized; 566 patients treated at least 1 migraine and were included in the tolerability assessment (565 patients were included in the intent-to-treat population).

Intervention: Patients were randomized to either zolmitriptan 2.5 mg ODT or placebo. Patients treated up to 2 migraine attacks as soon as possible after the start of their migraine pain.

Main outcome measure: Pain-free rates at 2 h.

Results: Zolmitriptan 2.5 mg ODT (n = 281) demonstrated a significant pain-free rate vs. placebo (n = 284) at 2 h (40% vs. 20%, p < 0.001), 1.5 h (25% vs. 15%, p < 0.001), and 1 h (13% vs. 8%, p = 0.004). Sustained pain-free rate was significantly higher than placebo (31% vs. 15%; p < 0.001). Return to normal activities favored zolmitriptan 2.5 mg ODT at 1 h (p = 0.004), 1.5 h (p < 0.001), and 2 h (p < 0.001). Adverse events associated with zolmitriptan 2.5 mg ODT were those commonly reported with the use of triptans.

Conclusions: Zolmitriptan 2.5 mg ODT, taken as early as possible after onset of a migraine attack, is effective in the treatment of migraine, producing a significantly higher pain-free rate than placebo 2 h post-dose, and also at the earlier time points of 1 h and 1.5 h post-dose.

Keywords: EFFICACY; MIGRAINE; ORALLY DISINTEGRATING TABLET; TOLERABILITY; ZOLMITRIPTAN

Document Type: Research article

DOI: 10.1185/030079905X28926

Affiliations: 1: Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, USA 2: Diamond Headache Clinic, Finch University of Health Sciences/Chicago Medical School, Chicago, IL, USA 3: Headache Wellness Center, Greensboro, NC, USA 4: Savannah, GA, USA 5: Teaneck, NJ, USA

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