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Allodynia-associated symptoms, pain intensity and time to treatment: predicting treatment response in acute migraine intervention. Headache 2009 Mar;49(3):350-63 PMID: 19220503

Pubmed ID

19220503

Abstract

OBJECTIVE: To evaluate the relationship between treatment outcomes and allodynia-associated symptoms (AAS) at the time of treatment with almotriptan.

METHODS: Analyses were performed with data collected prospectively from patients in 2 recently completed early intervention trials, AXERT Early miGraine Intervention Study (AEGIS) and AXERT 12.5 mg time vs Intensity Migraine Study (AIMS): 2-hour pain free, 2-hour pain relief (AEGIS only), sustained pain free (SPF), use of rescue medication, and median headache duration (AIMS only), in the presence and absence of pretreatment AAS, which was determined by responses to a questionnaire. Analyses were conducted to evaluate possible prognostic variables.

RESULTS: The presence of pretreatment AAS did not have a significant effect on 2-hour pain-free, 2-hour pain-relief or SPF rates, use of rescue medication, or headache duration. Significant factors for most favorable outcomes (greater 2-hour pain-free, 2-hour pain-relief and SPF rates, less use of rescue medication, and shorter headache duration) included treatment with almotriptan 12.5 mg, treatment of mild or moderate headache pain, and treatment within 1 hour of headache onset.

CONCLUSION: Almotriptan 12.5 mg was efficacious in providing 2-hour pain free, 2-hour pain relief, SPF, and reducing rescue medication use irrespective of the presence of AAS at the time of treatment. The most optimal efficacy outcomes occurred when patients treated migraine attacks early and before the onset of severe pain. The presence of AAS, which may indicate an early phase of allodynia, did not influence the efficacy of almotriptan therapy.

Author List

Cady RK, Freitag FG, Mathew NT, Elkind AH, Mao L, Fisher AC, Biondi DM, Finlayson G, Greenberg SJ, Hulihan JF

Author

Frederick G. Freitag DO Associate Professor in the Neurology department at Medical College of Wisconsin




Scopus

2-s2.0-61349189613   15 Citations

MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Aged
Double-Blind Method
Female
Humans
Hyperesthesia
Male
Middle Aged
Migraine Disorders
Pain Measurement
Pain Threshold
Retrospective Studies
Serotonin Receptor Agonists
Time Factors
Treatment Outcome
Tryptamines
Young Adult
jenkins-FCD Prod-296 4db9d02597e0a2e889e230f853b641c12f1c3ee3