Effect of high-dose intravenous eletriptan on coronary artery diameter.

Author(s): Goldstein JA, Massey KD, Kirby S, Gibson M, Hettiarachchi J, Rankin AJ, Jackson NC

Affiliation(s): William Beaumont Hospital, Royal Oak, MI 48073, USA. jgoldstein@beaumont.edu

Publication date & source: 2004-07, Cephalalgia., 24(7):515-21.

Publication type: Clinical Trial; Randomized Controlled Trial

The goal of this study was to evaluate the coronary vasoconstrictive effects of high doses of eletriptan compared with a standard dose of sumatriptan. Patients with no clinically significant coronary artery disease were randomized to receive high-dose intravenous eletriptan (n = 24) vs a standard dose of sumatriptan (n = 18; 6 mg subcutaneously) vs placebo (n = 18). Serial angiograms were obtained. The primary non-inferiority analysis found equivalence between the mean maximum change in left anterior descending coronary artery diameter for eletriptan, -22%[95% confidence interval (CI) -26, -19], and sumatriptan, -19% (95% CI -22, -16). The change due to placebo was -16% (95% CI -20, -12). No individual cases of clinically significant vasoconstriction were observed. The results confirm that eletriptan has a broad cardiovascular safety margin, with plasma concentrations comparable to three to five times the Cmax of an oral 80-mg dose associated with modest vasoconstriction equivalent to standard therapeutic doses of sumatriptan.