Effectiveness of eletriptan in reducing time loss caused by migraine attacks

Background: The growing literature on the economics of migraine and its tre atment generally indicates that the direct healthcare costs of managing the disorder are relatively low compared with the personal and societal burden s resulting from the disruption to normal functioning caused by migraine at tacks. Objective: To investigate the effectiveness of eletriptan, a new selective serotonin (5-hydroxytryptamine; 5-HT) 5-HT(IB/ID)agonist, in reducing both the patient-focused burden of migraine and the amount of work time foregone during a single attack. Design: In a phase III, multinational, randomised clinical trial, 692 patie nts treated a migraine attack with eletriptan 40mg or 80mg, or placebo. Pat ients responded to a questionnaire seeking information concerning the amoun t of time lost from usual activities during the attack. Time loss assessmen ts were made 24 hours after the last dose taken and recorded in a diary. Main outcome measures and results: Patients receiving either dose of the ac tive compound were unable to perform their usual activities for a median pe riod of 4 hours compared with 9 hours experienced by those taking placebo. This difference was highly statistically significant (p < 0.001). The time saving associated with eletriptan usage reflected the differences in effica cy findings in the clinical component of the study. Conclusion: In this placebo-controlled trial, eletriptan produced a signifi cant reduction in the loss of usual functioning time associated with a migr aine attack. This gain clearly represents a substantial benefit to patients with migraine irrespective of how it might most appropriately be valued in monetary terms. Further methodological progress in this area is warranted.