Treatment of Acute Migraine With Subcutaneous Sumatriptan
- Roger K. Cady, MD;
- Jeanette K. Wendt, MD;
- John R. Kirchner, MD;
- Joseph D. Sargent, MD;
- John F. Rothrock;
- Harold Skaggs, Jr, MD
- From the Shealy Institute for Comprehensive Health Care, Springfield, Mo (Dr Cady); Department of Neurology, Health Science Center, University of Arizona, Tucson (Dr Wendt); the Migraine Treatment Clinic, Omaha, Neb (Dr Kirchner); Headache and Internal Medicine Research Center, Menninger, Topeka, Kan (Dr Sargent); Department of Neurology, University of California at San Diego Medical Center (Dr Rothrock); Neurology Section, Center for Clinical Research, Austin, Tex (Dr Skaggs); on behalf of the US Sumatriptan Research Group.; Dr Cady owns stock in Glaxo Pharmaceuticals Inc.
Abstract
Sumatriptan succinate, a 5-HT1D receptor agonist, constricts human cranial arteries. Two parallel-group trials for treatment of acute migraines were conducted in the United States. Adult patients were randomized and given either 6 mg of sumatriptan succinate subcutaneously (n = 734) or placebo (n = 370). At 1 hour, sumatriptan was significantly more effective than placebo in reducing moderate or severe headache pain to mild or no pain (70% vs 22%), in completely relieving headaches (49% vs 9%), and in improving clinical disability (76% vs 34%). Sumatriptan also reduced nausea and photophobia significantly better than placebo. Patients with residual migraines received another injection; those who had originally received sumatriptan received either a second active injection (n = 187) or placebo (n = 178), while those who had received placebo received a second placebo injection (n = 335). Statistical evidence for benefit of second sumatriptan injection is absent. Adverse events associated with sumatriptan were tingling, dizziness, warm-hot sensations, and injection-site reactions. Sumatriptan is effective and well tolerated in patients with acute migraine.
(JAMA. 1991;265:2831-2835)
Footnotes
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Reprint requests to Shealy Institute for Comprehensive Health Care, 1328 E Evergreen St, Springfield, MO 65803 (Dr Cady).
