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European Journal of Clinical Pharmacology

, Volume 75, Issue 10, pp 1369–1378 | Cite as

Efficacy of triptans for the treatment of acute migraines: a quantitative comparison based on the dose-effect and time-course characteristics

  • Mengyuan Hou
  • Hongxia Liu
  • Yunfei Li
  • Ling Xu
  • Yingchun He
  • Yinghua Lv
  • Qingshan ZhengEmail author
  • Lujin LiEmail author
Pharmacodynamics
  • 172 Downloads

Abstract

Objectives

This study aimed to establish a pharmacodynamic model to quantitatively compare the efficacy characteristics of seven kinds of triptans and their different dosage forms in the treatment of acute migraines.

Methods

Clinical studies of triptans in the treatment of acute migraines were comprehensively searched in the public databases. Pharmacodynamic models were established to describe the dose-effect and time-course of each kind of triptan for the proportion of patients who became pain free or had pain relief.

Results

A total of 92 articles involving 47,376 subjects were included in the analysis. After eliminating the placebo effect, oral eletriptan (40 mg) had the highest efficacy among all oral drugs at the maximum approved dose, and the proportion of patients who became pain free and had pain relief were 30.9% and 37.9% at 2 h, respectively. However, oral naratriptan (2.5 mg) had the lowest efficacy, and the proportion of patients who became pain free and had pain relief was 10.3% and 21.6% at 2 h, respectively. The efficacy of subcutaneous administration was significantly higher than that of oral administration, and the efficacy of nasal spray administration was comparable to that of oral administration. Regarding the dose-effect, the efficacy of the sumatriptan nasal spray significantly increased within the FDA (Food and Drug Administration)-approved dose range. When the dose was increased from 5 to 20 mg of sumatriptan nasal spray, the proportion of patients who became pain free and had pain relief increased by 16.8% and 18.3% at 2 h, respectively. Regarding the time-course, the time of onset of subcutaneous sumatriptan (6 mg) was the fastest, and the fraction of patients who were pain free at 2 h accounted for 90.6% of that at 4 h.

Conclusions

This study evaluated the efficacy characteristics of seven kinds of triptans and their different dosage forms. The present findings provide necessary quantitative information for migraine medication guidelines.

Keywords

Migraine Triptans Dose-effect Time-course Pain-free Pain-relief 

Notes

Acknowledgments

This study was provided by the Drug Innovation Major Project (2018ZX09711001-009, 2018ZX09734005-001-002, 2018ZX09734005-006, 2018ZX09731016, 2017ZX09304003), the project of Shanghai Municipal Health Planning Commission (2018YQ48), and Science and Technology Innovation Action Plan of Shanghai (17401970900).

Authors’ contributions

Mengyuan Hou and Hongxia Liu contributed equally to this work; all the information was independently extracted by two researchers. All authors read and approved the final manuscript.

Funding information

This study was provided by the Drug Innovation Major Project (2018ZX09711001-009, 2018ZX09734005-001-002, 2018ZX09734005-006, 2018ZX09731016, 2017ZX09304003), the project of Shanghai Municipal Health Planning Commission (2018YQ48), and Science and Technology Innovation Action Plan of Shanghai (17401970900).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no competing interests.

Supplementary material

228_2019_2748_MOESM1_ESM.docx (732 kb)
ESM 1 (DOCX 732 kb)

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Mengyuan Hou
    • 1
  • Hongxia Liu
    • 1
  • Yunfei Li
    • 1
  • Ling Xu
    • 1
  • Yingchun He
    • 1
  • Yinghua Lv
    • 1
  • Qingshan Zheng
    • 1
    Email author
  • Lujin Li
    • 1
    Email author
  1. 1.Center for Drug Clinical ResearchShanghai University of Traditional Chinese MedicineShanghaiChina

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