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Title: IHS: Naratriptan Prevents Recurrent Headache After Initial Relief with Sumatriptan
URL: http://www.pslgroup.com/dg/1FFCF6.htm
Doctor's Guide
July 2, 2001


By Jill Stein
Special to DG News

NEW YORK, NY -- July 2, 2001 -- Naratriptan reduces the rate of headache recurrence after initial relief with sumatriptan in migraineurs with a high frequency of recurrence, a research group reported at the 10th Congress of the International Headache Society (IHS).

Naratriptan is a long-acting triptan and sumatriptan is a short-acting triptan.

Dr. Mark I. Harris and colleagues at Comprehensive Neurology Specialists in Atlanta, Georgia, conducted an open-label study in adult migraineurs who had an established history of migraine headache recurrence in at least 50 percent of their headaches after successful abortive therapy with a short- acting triptan.

Recurrence was defined as a return of headache within 24 hours after the initial dose of any short-acting triptan. For study purposes, patients were provided with sumatriptan to treat their migraines.

In order to be eligible for the trial, migraineurs had to experience two to six migraines per month.

At the onset of migraine, subjects took a sumatriptan oral tablet 50 mg or nasal spray 20 mg, and recorded their symptoms at the time of sumatriptan administration and then at 30, 60, 90, and 120 minutes.

If the initial dose of sumatriptan provided pain relief, subjects took naratriptan 2.5 mg at two hours after the sumatriptan. They then recorded the time and severity of any recurrence. Subjects were instructed to treat at least three migraines.

If there was no meaningful relief following initial sumatriptan treatment, then naratriptan was not taken and the patient could take a second dose of sumatriptan.

Overall, 13 patients treated 43 headaches. In 33 (77 percent) of 43 headaches, meaningful relief was obtained with a single dose of sumatriptan regardless of the formulation. No recurrence occurred in 28 (85 percent) of these headaches following administration of naratriptan 2.5 mg. Historically, recurrence would have been expected in at least 17 of the 33 headaches.

In those headaches with recurrence despite naratriptan administration, the mean time to recurrence was 15.4 hours.

The combination of sumatriptan and naratriptan was well tolerated. There were no dropouts due to adverse events.

Dr. Harris said that large, randomized, double-blind, placebo-controlled studies are needed to confirm the results of this open-label trial.

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