Frovatriptan vs. other triptans for the acute treatment of oral
contraceptive-induced menstrual migraine: pooled analysis of three double-blind,
randomized, crossover, multicenter studies.
Author(s): Allais G(1), Tullo V, Omboni S, Pezzola D, Zava D, Benedetto C, Bussone G.
Affiliation(s): Author information:
(1)Department of Gynecology and Obstetrics, Women's Headache Center, University of
Turin, Via Ventimiglia 3, 10126 Turin, Italy. gb.allais@tiscali.it
Publication date & source: 2013, Neurol Sci. , 34 Suppl 1:S83-6
Oral contraceptive-induced menstrual migraine (OCMM) is a particularly severe
form of migraine triggered by the cyclic hormone withdrawal. To review the
efficacy of frovatriptan vs. other triptans, in the acute treatment of OCMM
through a pooled analysis of three individual randomized Italian studies. With or
without aura migraineurs were randomized to frovatriptan 2.5 mg or rizatriptan 10
mg (study 1), frovatriptan 2.5 mg or zolmitriptan 2.5 mg (study 2), frovatriptan
2.5 mg or almotriptan 12.5 mg (study 3). All studies had a multicenter,
randomized, double-blind, crossover design. After treating 1-3 episodes of
migraine in 3 months with the first treatment, patients switched to the other
treatment for the next 3 months. In this analysis, the subset of 35 of the 280
women of the intention-to-treat population taking combined oral contraceptives
and experiencing a migraine attack during the withdrawal phase, were analyzed.
The proportion of pain free and pain relief at 2 h were 25 and 51 % with
frovatriptan and 28 and 48 % with comparators (p = NS). At 24 h, 71 and 83 % of
frovatriptan-treated patients and 60 and 76 % of comparator-treated patients were
pain free (p < 0.05 between treatments) and had pain relief (p = NS),
respectively. Relapse at 24 and 48 h was significantly (p < 0.05) lower with
frovatriptan (17 and 21 %) than with the comparators (27 and 31 %). Our results
suggest that, due to its sustained antimigraine effect, frovatriptan may be
particularly suitable for the management of OCMM than other triptans.
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