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Efficacy of frovatriptan and other triptans in the treatment of acute migraine of normal weight and obese subjects: a review of randomized studies

  • SYMPOSIUM Migraine and its varieties
  • Published:
Neurological Sciences Aims and scope Submit manuscript

Abstract

An association between obesity and migraine has been observed in recent studies and it is supported by plausible biological mechanisms. The objective of this study is to evaluate the efficacy of frovatriptan and other triptans in the acute treatment of migraine, in patients enrolled in three randomized, double-blind, crossover, Italian studies and classified according to body mass index (BMI) levels, as normal weight or non-obese (NO, BMI 18.5–24.9 kg/m2) and overweight or obese subjects (O, BMI ≥ 25 kg/m2). 414 migraineurs with or without aura were randomized to frovatriptan 2.5 mg or rizatriptan 10 mg (study 1), frovatriptan 2.5 mg or zolmitriptan 2.5 mg (study 2), frovatriptan 2.5 mg or almotriptan 12.5 mg (study 3). After treating up to three episodes of migraine in 3 months with the first treatment, patients switched to the alternate treatment for the next 3 months. The present analysis assessed triptan efficacy in 220 N and in 109 O subjects of the 346 individuals of the intention-to-treat population. The proportion of pain free at 2 h did not significantly differ between frovatriptan and the comparators in either NO (30 vs. 34 %) or O (24 vs. 27 %). However, the rate of pain free at 2 h was significantly (p < 0.05) larger in NO than in O, irrespective of the type of triptan. Pain relief at 2 h was also similar between drug treatments for either subgroup. Pain relapse occurred at 48 h in significantly (p < 0.05) fewer episodes treated with frovatriptan in both NO (26 vs. 36 %) and O (27 vs. 49 %). The rate of 48-h relapse was similar in NO and O with frovatriptan, while it was significantly (p < 0.05) higher in O with the comparators. Frovatriptan, in contrast to other triptans, retains a sustained antimigraine effect in NO and even more so in O subjects.

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Acknowledgments

The present study was supported by Istituto Lusofarmaco d’Italia S.P.A. Authors gratefully thank Dr. Stephen Pawsey of Vernalis Ltd. for his valuable suggestions which helped to improve the quality of the manuscript.

Conflict of interest

All authors have occasionally served as scientific consultants for manufacturers of frovatriptan, rizatriptan, zolmitriptan or almotriptan. Deborha Pezzola and Dario Zava are employees of the manufacturer of frovatriptan.

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Authors and Affiliations

  1. Neurological Department Asti, Ospedale Cardinal Massaia, ASL AT-Asti, Via Conte Verde 125, Asti, Italy

    Maria Gabriella Saracco & Marco Aguggia

  2. Women’s Headache Center, Department of Surgical Sciences, University of Turin, Turin, Italy

    Gianni Allais & Chiara Benedetto

  3. Department of Clinical Neuroscience, National Neurological Institute Carlo Besta, Milan, Italy

    Vincenzo Tullo & Gennaro Bussone

  4. Istituto Lusofarmaco D’Italia S.P.A, Peschiera Borromeo, Italy

    Dario Zava & Deborha Pezzola

  5. Mediservice, Milan, Italy

    Giorgio Reggiardo

  6. Clinical Research Unit, Italian Institute of Telemedicine, Varese, Italy

    Stefano Omboni

Authors
  1. Maria Gabriella Saracco
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  2. Gianni Allais
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  3. Vincenzo Tullo
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  4. Dario Zava
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  5. Deborha Pezzola
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  6. Giorgio Reggiardo
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  7. Stefano Omboni
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  8. Chiara Benedetto
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  9. Gennaro Bussone
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  10. Marco Aguggia
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Correspondence to Maria Gabriella Saracco.

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Saracco, M.G., Allais, G., Tullo, V. et al. Efficacy of frovatriptan and other triptans in the treatment of acute migraine of normal weight and obese subjects: a review of randomized studies. Neurol Sci 35 (Suppl 1), 115–119 (2014). https://doi.org/10.1007/s10072-014-1752-2

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  • DOI: https://doi.org/10.1007/s10072-014-1752-2

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