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Triptans: Do they differ?

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Abstract

Headache care specialists agree that the introduction of sumatriptan constitutes a major advance in headache therapy, but they differ about whether other triptans offer clinically significant advantages over sumatriptan. This article examines this issue by considering the similarities and differences among triptans.

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References and Recommended Reading

  1. Gawel MJ, Worthington I, Maggisano A: A systematic review of the use of triptans in acute migraine. Can J Neurol Sci 2001, 28:30–41.

    PubMed  CAS  Google Scholar 

  2. Whitaker JN: Triptans for migraine headache: therapeutic progress meets a heterogeneous patient response. Arch Neurol 2001, 58:1482–1483.

    Article  PubMed  CAS  Google Scholar 

  3. Tepper SJ, Rapoport AM: The triptans: a summary. CNS Drugs 1999, 12:403–417.

    Article  CAS  Google Scholar 

  4. Saxena PR, Ferrari MD: 5HT1-like receptor agonists and the pathophysiology of migraine. Trends Pharmacol Sci 1989, 10:200–204.

    Article  PubMed  CAS  Google Scholar 

  5. Hargreaves RJ, Shepheard SL: Pathophysiology of migraine: new insights. Can J Neurol Sci 1999, 26(3):S12-S19. This reference provides a comprehensive synthesis of the most recent developments in the understanding of migraine pathophysiology.

    PubMed  Google Scholar 

  6. Humphrey PPA, Feniuk W, Perren MJ, et al.: Serotonin and migraine. Ann N Y Acad Sci 1990, 600:587–598.

    Article  PubMed  CAS  Google Scholar 

  7. Dahlöf C: Would any acute treatment for migraine demonstrate recurrence? Cephalalgia 1997, 17(Suppl 7):17–20.

    PubMed  Google Scholar 

  8. Tfelt-Hansen P, De Vries P, Saxena PR: Triptans in migraine: a comparative review of pharmacology, pharmacokinetics, and efficacy. Drugs 2000, 60:1259–1287.

    Article  PubMed  CAS  Google Scholar 

  9. Ferrari MD, Roon KI, Lipton RB, et al.: Oral triptans in acute migraine treatment: a meta-analysis of 53 trials. Lancet 2001, 358:1668–1675.

    Article  PubMed  CAS  Google Scholar 

  10. Rapoport AM, Tepper SJ: Triptans are all different. Arch Neurol 2001, 58:1479–1480.

    Article  PubMed  CAS  Google Scholar 

  11. Saper JR: What matters is not the differences between triptans, but the differences between patients. Arch Neurol 2001, 58:1481–1482.

    Article  PubMed  CAS  Google Scholar 

  12. Schoenen J: Acute migraine therapy: the newer drugs. Curr Opin Neurol 1997, 10:237–243.

    Article  PubMed  CAS  Google Scholar 

  13. Goadsby PJ: Serotonin receptor agonists in migraine: comparative pharmacology and its therapeutic implication. CNS Drugs 1998, 10:271–286.

    Article  CAS  Google Scholar 

  14. Goadsby PJ: The scientific basis of medication choice in symptomatic migraine treatment. Can J Neurol Sci 1999, 26(Suppl 3):S20-S26.

    PubMed  Google Scholar 

  15. Spencer CM, Gunasekara NS, Hills C: Zolmitriptan: a review of its use in migraine. Drugs 1999, 58:347–374.

    Article  PubMed  CAS  Google Scholar 

  16. Salonen R: Drug comparisons: why are they so difficult? Cephalalgia 2000, 20(Suppl_2):25–32. This reference reviews methodologic and interpretational issues in comparing triptans and helps readers draw informed conclusions about the results of comparator clinical trials.

    Article  PubMed  Google Scholar 

  17. Goadsby PJ, Ferrari MD, Olesen J, et al.: Eletriptan in acute migraine: a double-blind, placebo-controlled comparison to sumatriptan. Neurology 2000, 54:156–163.

    PubMed  CAS  Google Scholar 

  18. Fuseau E, Petricoul O, Sabin A, et al.: Encapsulation delays absorption of sumatriptan tablets: data from healthy volunteers and patients during a migraine. Clin Ther 2001, 23:242–251.

    Article  PubMed  CAS  Google Scholar 

  19. Geraud G, Olesen J, Pfaffenrath V, et al.: Comparison of the efficacy of zolmitriptan and sumatriptan: issues in migraine trial design. Cephalalgia 2000, 20:30–38.

    Article  PubMed  CAS  Google Scholar 

  20. Gallagher RM, Dennish G, Spierings EL, et al.: A comparative trial of zolmitriptan and sumatriptan for the acute oral treatment of migraine. Headache 2000, 40:119–128.

    Article  PubMed  CAS  Google Scholar 

  21. Tfelt-Hansen P, Teall J, Rodriguez F, et al.: Oral rizatriptan versus oral sumatriptan: a direct comparative study in the acute treatment of migraine. Headache 1998, 38:748–755.

    Article  PubMed  CAS  Google Scholar 

  22. Goldstein J, Ryan R, Jiang K, et al.: Crossover comparison of rizatriptan 5 mg and 10 mg versus sumatriptan 25 mg and 50 mg in migraine. Headache 1998, 38:737–747.

    Article  PubMed  CAS  Google Scholar 

  23. Visser WH, Terwindt GM, Reines SA, et al.: Rizatriptan vs sumatriptan in the acute treatment of migraine: a placebo-controlled, dose-ranging study. Arch Neurol 1996, 53:1132–1137.

    PubMed  CAS  Google Scholar 

  24. Pitman V, Forster E, Jackson NJ: Comparison of the efficacy of oral eletriptan and oral sumatriptan for the acute treatment of migraine: combined analysis across three clinical trials [abstract]. Headache 1999, 39:374.

    Google Scholar 

  25. Lynes C, Visser WH, Vandormael K, et al.: Rizatriptan 5 mg versus sumatriptan 50 mg in the acute treatment of migraine [abstract]. Headache 1997, 37:319–320.

    Google Scholar 

  26. Van DenBrink A, Reekers M, Bax WA, et al.: Coronary side-effect potential of current and prospective antimigraine drugs. Circulation 1998, 98:25–30.

    Google Scholar 

  27. Van DenBrink A, van den Broek RWM, de Vries R, et al.: Cardiovascular selectivity of eletriptan and sumatriptan in human isolated blood vessels. Neurology 2000, 55:1524–1530.

    Google Scholar 

  28. Zolmitriptan Prescribing Information. AstraZeneca: Wilmington, DE; 1999.

  29. Rizatriptan Prescribing Information. Merck: Whitehouse Station, NJ; 1999.

  30. Pryse-Phillips W, on behalf of the Eletriptan Steering Committee: Comparison of oral eletriptan and oral sumatriptan for the treatment of acute migraine: a randomized placebo-controlled trial in sumatriptan-naíve patients [abstract]. Cephalalgia 1999, 19:355–356.

    Google Scholar 

  31. Fowler PA, Lacey LF, Thomas M, et al.: The clinical pharmacology, pharmacokinetics, and metabolism of sumatriptan. Eur Neurol 1991, 31:291–294.

    PubMed  CAS  Google Scholar 

  32. Scott AK, Walley T, Breckenridge AM, et al.: Lack of an interaction between propranolol and sumatriptan. Br J Clin Pharmacol 1991, 32:581–584.

    PubMed  CAS  Google Scholar 

  33. Van Hecken AM, Depré M, De Schepper PJ, et al.: Lack of effect of flunarizine on the pharmacokinetics and pharmacodynamics of sumatriptan in healthy volunteers. Br J Clin Pharmacol 1992, 34:82–84.

    PubMed  Google Scholar 

  34. Dowson AJ, Ashford EA, Prendergast S, et al.: Patient-selected dosing in a 6-month open-label study evaluating oral sumatriptan in the acute treatment of migraine. Int J Clin Pract suppl 1999, 105:25–33.

    PubMed  CAS  Google Scholar 

  35. Salonen R, Ashford EA, Gibbs M, et al.: Patient preference for oral sumatriptan 25 mg, 50 mg, or 100 mg in the acute treatment of migraine: a double-blind, randomized, crossover study. Int J Clin Pract suppl 1999, 105:16–24.

    PubMed  CAS  Google Scholar 

  36. Welch KMA, Mathew NT, Stone P, et al.: Tolerability of sumatriptan: clinical trials and post-marketing experience. Cephalalgia 2000, 20:687–694. This reference describes the extensive studies establishing the cardiovascular safety profile of sumatriptan. The information is helpful to the prescribing clinician in evaluating the safety of sumatriptan and sumatriptan-like compounds.

    Article  PubMed  CAS  Google Scholar 

  37. Cady RK, Lipton RB, Hall C, et al.: Treatment of mild headache in disabled migraine sufferers: results of the Spectrum Study. Headache 2000, 40:792–797.

    Article  PubMed  CAS  Google Scholar 

  38. Cady RK, Sheftell F, Lipton RB, et al.: Effect of early intervention with sumatriptan on migraine pain: retrospective analyses of data from three clinical trials. Clin Ther 2000, 22:1035–1048.

    Article  PubMed  CAS  Google Scholar 

  39. Sumatriptan Cluster Headache Study Group: Treatment of acute cluster headache with sumatriptan. N Engl J Med 1991, 325:322–326.

    Article  Google Scholar 

  40. Ekbom K, Monstad I, Prusinski A, et al.: Subcutaneous sumatriptan in the acute treatment of cluster headache: a dose-comparison study. Acta Neurol Scand 1993, 88:63–69.

    Article  PubMed  CAS  Google Scholar 

  41. Bousser MG, D’Allens H, Richard A: Efficacy of subcutaneous sumatriptan in the acute treatment of early-morning migraine: a placebo-controlled trial. J Intern Med 1993, 234:211–216.

    Article  PubMed  CAS  Google Scholar 

  42. Salonen R, Saiers J: Sumatriptan is effective in the treatment of menstrual migraine: a review of prospective studies and retrospective analyses. Cephalalgia 1999, 19:16–19.

    Article  PubMed  CAS  Google Scholar 

  43. O’Quinn S, Ephross SA, Williams V, et al.: Pregnancy and perinatal outcomes in migraineurs using sumatriptan: a prospective study. Arch Gynecol Obstet 1999, 263:7–12.

    Article  PubMed  CAS  Google Scholar 

  44. Reiff-Eldridge R, Heffner CR, Ephross SA, et al.: Monitoring pregnancy outcomes after prenatal drug exposure through prospective pregnancy registries: a pharmaceutical company commitment. Am J Obstet Gynecol 2000, 182:159–163.

    Article  PubMed  CAS  Google Scholar 

  45. The Subcutaneous Sumatriptan International Study Group: Treatment of migraine attacks with sumatriptan. N Engl J Med 1991, 325:316–321.

    Article  Google Scholar 

  46. Cady RK, Wendt JK, Kirchner JF, et al.: Treatment of acute migraine with subcutaneous sumatriptan. JAMA 1991, 265:2831–2835.

    Article  PubMed  CAS  Google Scholar 

  47. Cohen JA, Beall DG, Miller DW, et al.: Subcutaneous sumatriptan for the treatment of migraine: humanistic, economic, and clinical consequences. Fam Med 1996, 28:171–178.

    PubMed  CAS  Google Scholar 

  48. Bousser MG, D’Allens H, Richard A: Efficacy of subcutaneous sumatriptan in the acute treatment of early-morning migraine: a placebo-controlled trial. J Intern Med 1993, 234:211–216.

    PubMed  CAS  Google Scholar 

  49. Dahlöf C: Sumatriptan nasal spray in the acute treatment of migraine: a review of clinical studies. Cephalalgia 1999, 19:769–778.

    Article  PubMed  Google Scholar 

  50. Zomig (zolmitriptan) nasal spray offers effective, convenient alternative for migraine. Doctor’s Guide. Available at: http://www.pslgroup.com/dg/1FFAEE.htm. Accessed December 12, 2001.

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Authors and Affiliations

  1. GlaxoSmithKline, Five Moore Drive, 27709, Research Triangle Park, NC, USA

    Reijo Salonen MD, PhD & Andrew Scott PharmD

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  1. Reijo Salonen MD, PhD
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  2. Andrew Scott PharmD
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Salonen, R., Scott, A. Triptans: Do they differ?. Current Science Inc 6, 133–139 (2002). https://doi.org/10.1007/s11916-002-0009-6

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  • DOI: https://doi.org/10.1007/s11916-002-0009-6

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