SUBCUTANEOUS SUMATRIPTAN IN A CLINICAL SETTING - THE 1ST 100 CONSECUTIVE PATIENTS WITH ACUTE MIGRAINE IN A TERTIARY CARE CENTER

The first 100 consecutive patients at our center receiving subcutaneou s sumatriptan (6 mg) were evaluated over a total of 455 migraine attac ks. Parameters included overall efficacy, average time to relief, recu rrence rate, average time to recurrence, adverse events, comparison to previous abortive agents, and subjective global ratings. Overall effi cacy (defined as headache severity reduction from severe or moderate t o mild or none) was 84%. Average time to relief was 40 minutes. Nine p ercent failed to respond at all. Recurrence rate was 46.5% with 36% of patients having no recurrence. Fourteen percent of patients reported 100% recurrence (minimum 3 attacks; average 5.4 attacks). Time to recu rrence varied widely, but averaged 9.1 hours. Eighty-one percent rated the drug better or much better than previous abortive medications in terms of sumatriptan's ability to abort the attack. Seventy-seven perc ent reported some adverse event (generally mild and transient) with 23 % reporting no adverse events. Sixty-nine percent reported a global ra ting of Good to Excellent and 31% rated Poor or Fair. The rate of recu rrence and average time to recurrence were the most significant factor s affecting the global ratings. These parameters were further evaluate d with respect to a variety of subgroups: 1) migraine alone 2) migrain e with co-existent tension-type headache 3) drug-induced headache (ana lgesic rebound headache) 4) posttraumatic headache 5) preventive versu s no preventive medication 6) presence or absence of adverse events 7) presence or absence of recurrence and 8) average duration of migraine with no medication.