A review of recent clinical experience with almotriptan.

摘要

The purpose of this paper is to review six recently completed trials (three double-blind, three open-label) providing valuable data on efficacy and tolerability of almotriptan in 'real world' settings. In a randomized double-blind trial, almotriptan 12.5 mg and zolmitriptan 2.5 mg achieved similar efficacy rates whereas almotriptan was associated with a lower rate of triptan-associated adverse events (AE). In another randomized double-blind trial, almotriptan patients achieved significantly higher 2-h pain-free, 2-h pain-relief and sustained pain-free rates than those receiving ergotamine plus caffeine. A third double-blind trial, enrolling patients with a history of poor response to sumatriptan (confirmed in a prerandomization attack), showed that patients receiving almotriptan had significantly higher 2-h pain-free, 2-h pain-relief and sustained pain-free rates compared with those receiving placebo. An open-label trial found similar rates of preference for almotriptan and rizatriptan 10 mg; similar rates were also seen for 2-h pain free, 2-h pain relief and sustained pain free. The German Migraine Register (open-label) found triptans to be associated with greater treatment satisfaction than non-specific agents; almotriptan and sumatriptan were linked to the highest levels of patient satisfaction. Another open-label satisfaction study showed that in comparison with previous therapies, almotriptan was associated with higher rates of pain relief, tolerability, resumption of normal activities, and the use of only one dose. In summary, the high levels of efficacy and tolerability reported for almotriptan 12.5 mg in earlier placebo-controlled clinical trials can be reproduced in 'real-world' clinical settings, and are consistent with previous trials showing almotriptan to have the ideal profile for an acute migraine treatment, that is, a balance between high efficacy and low AEs.