Abstract
BackgroundTriptans, specific symptomatic medications for migraine, are not effective in a proportion of patients, or in all attacks, hence the importance of identifying predictors of response. Our aim was to investigate the association between the efficacy of oral frovatriptan 2.5 mg and clinical characteristics of migraine attacks.MethodsWe enrolled 29 consecutive patients affected by migraine without aura at the Headache Center of “Mondino” Institute of Pavia. Each patient was given a diary and asked to record prospectively the features of three consecutive migraine attacks while using frovatriptan. A generalized estimating equations approach was used to determine phenotypic features associated with the pain free response at 2 hours.ResultsParticipants provided complete data for 85 attacks. Thirty of these (34%) patients reported being pain free 2 hours after taking frovatriptan 2.5 mg intake. Unilateral pain, presence of phonophobia, presence of one or more cranial autonomic symptoms and presence of one or more premonitory symptom were each associated with being pain free at 2 hours.ConclusionsThe response to frovatriptan was associated with particular features of the migraine attack, either before or during the pain phase of attacks. The data support larger studies to explore detailed attack phenotyping, with particular attention to early signs, to enable individualized treatment in migraine.
Highlights
Migraine has been identified as the second most disabling disorder worldwide [1]
The remaining 29 patients successfully recorded the features of three consecutive migraine attacks whilst using frovatriptan 2.5 mg, providing data for a total of 87 attacks
Our study suggests that deep phenotyping as a strategy to develop personalized approaches to the acute treatment of migraine is practical
Summary
Serotonin 5-HT1B/1D receptor agonists [2], provide the most effective symptomatic treatment for migraine, both efficacy and tolerability vary among molecules within this class of drugs and between individuals, including between attacks [3,4,5,6]. The basis for this variability remains to be determined. Results: Participants provided complete data for 85 attacks Thirty of these (34%) patients reported being pain free 2 hours after taking frovatriptan 2.5 mg intake. The data support larger studies to explore detailed attack phenotyping, with particular attention to early signs, to enable individualized treatment in migraine
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