THE EFFICACY OF SUBCUTANEOUS SUMATRIPTAN IN THE TREATMENT OF RECURRENCE OF MIGRAINE HEADACHE

Objectives-To investigate the efficacy of a second subcutaneous dose o f 6 mg sumatriptan in the treatment of recurrence of headache after su ccessful treatment of a migraine attack with an initial 6 mg dose. Met hods-In a prospective, randomised, placebo controlled, double blind, p arallel group study, 803 patients were treated for one to three migrai ne attacks with severe or moderate headache with a subcutaneous inject ion of 6 mg sumatriptan. Any subsequent recurrence of migraine headach e was treated with a randomised second injection of sumatriptan or pla cebo. Recurrence was defined as a headache of moderate or severe inten sity occurring 1-24 hours after the initial dose in a patient whose he adache had been relieved by sumatriptan (reduction of headache severit y from severe or moderate to mild or none after one hour). Results-Hea dache recurrence was reported by 10%-15% of patients. At each attack, 6 mg sumatriptan given subcutaneously was significantly (P < 0.0005) m ore effective than placebo at relieving recurrent headache after one h our (84%-93% v 31%-50% of patients); 76%-83% of patients reported head ache relief one hour after the initial dose of sumatriptan. Sumatripta n was generally well tolerated. Conclusions-Up to 15% of patients with migraine experience significant recurrence of headache after successf ul treatment with subcutaneous sumatriptan, and this recurrence is eff ectively treated by a further dose of subcutaneous sumatriptan.