A long-term study to maximise migraine relief with zolmitriptan

Part 1 of this international study was a randomized, double-blind, placebo- controlled study of 2.5 mg and 5 mg zolmitriptan (Zomig(T)) in the treatmen t of persistent migraine headache, two hours after an initial dose of 2.5 m g zolmitriptan use for treatment of initial, persistant and recurrent migra ine headaches. In Part 1, following the treatment of moderate or severe per sistant headache, two-hour headache response rates with 5 mg zolmitriptan ( 51.6%, n = 322), 2.5 mg zolmitriptan (49.7%, n = 324) and placebo (51.6%, n = 343) were not significantly different. However, the pain-free response r ate following the treatment of persistant migraine headache of any intensit y was significantly higher with 5 mg zolmitriptan than with placebo (36.0% vs. 25.5%; p < 0.001). This was predominantly due to effects in the subgrou p of patients with mild headache. Thus, migraine relief in patients whose i nitial headache shows a partial response to 2.4 mg zolmitriptan may be maxi mised by a second 5 mg dose. In Part 2 (involving 2499 evaluable patients), 65.8% of attacks were treated with a single dose of zolmitriptan, 70.3% re quired no further dose, similarly 62.7% of migraine attacks treated initial ly with 5 mg zolmitriptan only required a single dose. Over the whole attac k (i.e. initial and any persistant headache), headache response rates to on e or two zolmitriptan doses were greater than 88.8%. 'Level of pain' was th e primary factor influencing the choice od dose. zolmitriptan provided cons istent migraine headache relief in the majority of patients and was well to lerated.