Treatment of Mild Headache in Disabled Migraine Sufferers: Results of the Spectrum Study


Headache: The Journal of Head and Face Pain, Volume 40 Issue 10 Page 792 - November/December 2000: R.K. Cady, MD; R.B. Lipton, MD; C. Hall, PhD; W.F. Stewart, PhD; S. O'Quinn, PharmD; D. Gutterman, PharmD .

Objective.To evaluate the effectiveness of sumatriptan, 50-mg tablets, versus placebo for early intervention while head pain was mild in patients with disabling migraine.

Methods. A post hoc analysis was performed in a subgroup of patients from a large, randomized, placebo-controlled study of patients with disabling headache who treated while pain was mild. Pain-free response 2 and 4 hours postdose, headache recurrence, and safety were examined. Significance tests were performed only for the first-treated attacks.

Results.Twenty-six patients with disabling headache treated 46 mild and 166 moderate or severe headaches. For the first-treated headaches while pain was mild, pain-free rates were significantly higher for sumatriptan than placebo 4 hours postdose (78 versus 0, P = .02), but not 2 hours postdose (52 versus 0, P = .22). Across all headaches treated while pain was mild, pain-free responses were higher for sumatriptan than placebo 4 hours (85 versus 17) and 2 hours (50 versus 0) postdose compared with placebo. When the same patients treated headaches while pain was moderate or severe, pain-free rates were lower than that reported for treatment during mild pain. There was a trend toward lower headache recurrence in headaches treated while pain was mild compared with moderate or severe pain (13 versus 18). No drug-related adverse events were reported in the headaches treated while pain was mild.

Conclusions.Patients with disabling migraine may benefit from early intervention with sumatriptan, 50 mg, while pain is mild.

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Steven Richeimer, MD
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