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Sumatriptan Plus Non-Steroidal Anti-Inflammatory Drug Most Effective for Migraine: Presented at IHC

By Larry Schuster

ROME, ITALY -- September 30, 2003 -- A retrospective analysis of unpublished antimigraine drug trials found the combination of sumatriptan and a non-steroidal anti-inflammatory drug (NSAID) produces the fastest and greatest relief of both migraine pain and the associated symptoms at 4 hours post-treatment.

Ninan Mathew, MD, director, Houston Headache Clinic, Houston, Texas, United States, presented these results September 16^th here at the 11^th Congress of the International Headache Society.

In his presentation, Dr. Ninan said all results are based on a meta-analysis of data from double-blind, randomised, placebo-controlled clinical trials in about 300 migraine patients treated with the oral NSAIDs naproxen, sumatriptan, combination NSAID and sumatriptan, combination NSAID and antiemetic, or subcutaneous dihydroergotamine (DHE). Patients were given a single dose of medication.

The report was prepared to compare the various therapies on both migraine pain and associated symptoms of nausea, photophobia, and phonophobia.

In pain response, the analysis found that a combination of naproxen and sumatriptan was significantly more effective than other active treatments, and better than placebo at 1.5 hours after dosing. The other treatments resulted in a pain response in at most about 37% of patients, compared to nearly 50% for the naproxen/sumatriptan combination.

For nausea, only the naproxen/sumatriptan combination was significantly more effective than placebo at 2.5 hours after dosing.

For both photophobia and phonophobia, only the naproxen/sumatriptan combination was significantly more effective than placebo at 1.5 hours. The percentage of patients with photophobia at 1.5 hours with the combination was about 55%, compared to about 62% or more with the other treatments. The percentage of patients with phonophobia at 1.5 hours was about 48% with the naproxen/sumatriptan combination, compared to about 58% or more for the other treatments.

The researchers concluded that pain responded faster than any other symptom to any of the treatments, and nausea was slower to subside with active treatment than was pain, suggesting there may be differing mechanisms for migraine pain and associated nausea.

Dr. Mathew and his colleagues said the results indicate that "targeting more than one mechanism of pain is crucial in treating moderate to severe migraine."

The retrospective analysis was prepared in collaboration with POZEN, Inc., a pharmaceutical development company in Chapel Hill, North Carolina, United States.


[Study title: Time Course of Symptom Relief With Various Antimigraine Therapies. Abstract P5N32]

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