SUBCUTANEOUS SUMATRIPTAN IN ACUTE TREATMENT OF MIGRAINE - A MULTICENTER NEW-ZEALAND TRIAL

Aim. To assess the effectiveness of subcutaneous sumatriptan (4 mg) in the acute treatment of migraine. Methods. A randomised, double-blind, placebo controlled study was conducted in four New Zealand centres. O n developing an acute attack of migraine, patients attended a centre w here they were given either sumatriptan 4 mg or placebo by subcutaneou s injection. Headache severity and clinical disability were measured o ver a 2 hour period. Results. Fifty-one patients, aged 19-58 years wit h common or classical migraine were treated. Twenty-eight patients rec eived 4 mg sumatriptan and 23 patients received placebo. Pretreatment headache severity was graded moderate in 76% and severe in 24%. Thirty -two percent of patients were sufficiently disabled to require bed res t and a further 48% had severe impairment of working ability. Sumatrip tan was significantly more effective than placebo in relieving or redu cing headache severity after 30 minutes. Sixty-four percent improved o n sumatriptan compared to 27% on placebo. Functional disability, nause a, vomiting and photophobia were also greatly reduced. Adverse effects occurred in 17% of patients receiving placebo, and 82% receiving suma triptan, the commonest being injection site reactions. Conclusion. Sub cutaneous sumatriptan 4 mg is an effective and well-tolerated acute tr eatment in adult patients with moderate to severe common or classical migraine. The efficacy rate of 64% is lower than that found in recent controlled studies using a higher dose.