PRACTICABILITY AND ACCEPTANCE OF SUBCUTANEOUS SELF-ADMINISTRATION OF THE SELECTIVE SEROTONIN AGONIST SUMATRIPTAN

To cater to the special situation of much reduced oral bioavailability which occurs in severe migraine attacks with pronounced nausea and vo miting, sumatriptan can also be used in a subcutaneous form that can b e self-administered. The aim of this study was to analyze the practica bility and acceptance of a method of self-administration (''Glaxo-Pen' ') for treatment of severe migraine attacks by subcutaneous injection of sumatriptan. The Glare-Pen was compared with the conventional autoi njector for subcutaneous administration of sumatriptan. The multicente r study was conducted under practical conditions by 150 office-based p hysicians in Germany. Patients who commonly suffered from severe migra ine attacks were given a careful explanation of how to use the device (''Glaxo-Pen'') for self-administration of subcutaneous sumatriptan an d were able to practice using it under guidance. They were given a Gla re-Pen with two sumatriptan refills to take with them for treating the ir own migraine attacks. The patients used a headache diary to documen t administration outside the practice session. A total of 376 patients were included in the study. The major findings were that 80% of the p atients rated the Glare-Pen ''very easy'' or ''easy'' to use, and only 6.4% rated it ''difficult'' or ''very difficult.'' Compared with the conventional autoinjector, the Glare-Pen was rated ''much better'' or ''better'' by 77.9% of patients. Only 8.5% considered the Glare-Pen '' worse'' or ''much worse'' than the conventional autoinjector. The figu res show that the great majority of patients found it easy to use suma triptan for treating severe migraine attacks by self-administration un der practical conditions. Thus, especially for patients who suffer fro m severe nausea, vomiting, or diarrhea during migraine attacks, this m ethod of delivery is an easily used means of arresting migraine attack s.