C. Dahlof et al., ZOLMITRIPTAN, A 5-HT1B 1D RECEPTOR AGONIST FOR THE ACUTE ORAL TREATMENT OF MIGRAINE - A MULTICENTER, DOSE-RANGE FINDING STUDY/, European journal of neurology, 5(6), 1998, pp. 535-543
Zolmitriptan is a selective 5-HT1B/1D receptor agonist for acute oral
migraine therapy. This randomized, placebo-controlled, parallel-group
study investigated the efficacy and tolerability of oral zolmitriptan
(5, 10, 15 and 20 mg) in the treatment of single acute migraine attack
s. Of 1181 patients randomized, 840 were evaluable for the primary eff
icacy analysis. Headache response rates (a reduction in headache inten
sity from severe or moderate at baseline to mild or no pain at 2 hours
post-treatment) were similar across the zolmitriptan dose groups (66%
, 71%, 69% and 77% for 5 mg, 10 mg, 15 mg and 20 mg, respectively) and
were significantly higher than that for placebo (19%; all groups P <
0.001). A headache response was reported at 1 hour by 40-50% of zolmit
riptan recipients (16% placebo). At 2 hours post dose, 39-47% of zolmi
triptan-treated patients were pain-free, compared with 1% of placebo r
ecipients. Headache recurrence occurred in 21-29% (upper 95% CI 37.1)
of zolmitriptan-treated patients and in 65% (95% CI 38.3, 85.8) of pla
cebo recipients. Zolmitriptan was well tolerated at each dose. The mos
t commonly reported adverse events were asthenia, dizziness, paraesthe
sia and feelings of heaviness. Most adverse events were of mild or mod
erate intensity and were transient. The frequency of adverse events wa
s dose-related. Although, zolmitriptan 5 mg exhibited the most favoura
ble efficacy and tolerability profile, the dose response data suggest
that lower doses would also offer significant efficacy. Eur J Neurol 5
:535-543 (C) 1998 Lippincott Williams & Wilkins.