Focus on trial endpoints of clinical relevance and the use of almotriptan for the acute treatment of migraine

Int J Clin Pract. 2005 Nov;59(11):1356-65. doi: 10.1111/j.1368-5031.2005.00692.x.

Abstract

Almotriptan is a 5-HT(1B/1D) receptor agonist, or triptan, indicated for the acute treatment of migraine. It has been shown to be effective and well tolerated for the treatment of acute migraine in approximately 5000 patients enrolled in short-term placebo- and active-controlled trials and long-term open-label trials. A recent meta-analysis reported that almotriptan has the highest sustained pain-free (SPF) rate and lowest adverse-event (AE) rate of all oral triptans. Sustained pain free is a composite endpoint of pain freedom at 2 h, no recurrence of moderate-to-severe headache and no use of rescue medication from 2 to 24 h after dosing. Patient surveys have indicated that migraine sufferers consider complete pain relief, no recurrence, rapid onset and no side-effects to be the most important attributes of their acute treatment. Composite endpoints such as SPF and SPF with no AEs (SNAE) contain the attributes that migraine sufferers express as being the most important elements of an acute migraine therapy, and their use in future clinical trials should aid in the selection of agents that can offer patients the highest likelihood of consistent treatment success.

Publication types

  • Review

MeSH terms

  • Acute Disease
  • Humans
  • Migraine Disorders / drug therapy*
  • Product Surveillance, Postmarketing
  • Randomized Controlled Trials as Topic / methods
  • Serotonin Receptor Agonists / adverse effects
  • Serotonin Receptor Agonists / therapeutic use*
  • Treatment Outcome
  • Tryptamines / adverse effects
  • Tryptamines / therapeutic use*

Substances

  • Serotonin Receptor Agonists
  • Tryptamines
  • almotriptan