Eletriptan May Prove Superior to Sumatriptan

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Eletriptan May Prove Superior to Sumatriptan

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By Deborah

WESTPORT, Jan 11 (Reuters Health) - Compared with sumatriptan, eletriptan

appears to have a " ...superior efficacy, onset of action and patient

acceptability " for the treatment of acute migraine, a multicenter team reports

in the January issue of Neurology.

Dr. P. J. Goadsby of The National Hospital for Neurology and Neurosurgery in

London, UK, and colleagues conducted a phase II trial in which the safety and

efficacy of three doses of eletriptan, 20 mg, 40 mg, or 80 mg, were compared

with that of oral sumatriptan (100 mg) and placebo. The investigators evaluated

692 migraineurs who were randomized to one of these treatments for an acute

attack.

Dr. Goadsby's group found that " ...significantly more patients receiving

eletriptan (40 mg and 80 mg) reported headache improvement compared to patients

receiving sumatriptan (100 mg) and placebo, " according to a press release from

the University College London Hospitals.

In addition, as reported in the paper, " Headache-free rates at 2 hours were

superior to placebo (6%) for both the 80-mg dose of eletriptan (37%) and the

40-mg dose (29%), with the 80-mg dose also being superior to sumatriptan (23%). "

No serious drug-related effects were observed, and all treatments were

considered well tolerated. However, a higher overall incidence of side effects

was seen in the 80-mg eletriptan group compared with the other groups. The most

frequent drug-related side effects in both treatment groups were asthenia,

dizziness, somnolence and paresthesia.

" This latest of the triptans is able to compete with the standard triptan on its

own turf, " Dr. Goadsby commented to Reuters Health. Using the standard 2-hour

post-treatment response end-point, " ...this is the first of the triptans that

has been able to get itself head and shoulders above sumatriptan. "

" Eletriptan has more robust early time-point data than sumatriptan does, " he

continued. " Patients like the drug because it did tend to work quickly, and

patients value rapid onset of action and efficacy pretty much above everything

else. "

The results of phase III studies, which have also been successfully completed,

are similar to these findings, he continued, and eletriptan is currently under

review by the regulatory authorities in the UK and US.

Dr. Goadsby also stressed that physicians need to think of migraine " ...in terms

of its biology and in terms of its disability. " Eletriptan, along with other

triptans should be viewed " ...as another step in really being able to get on top

of what can be a dreadful condition. "

" What we don't want to lose sight of is the endgame, which is to minimize

disability due to migraine. " He believes that differences in efficacy are less

important than reducing the rate of undertreatment. " I'd like to see this kind

of information in some way be a springboard to having more people treated

better, rather than to argue about how to fine-tune those who already have

treatment. "

Dr. Goadsby hopes that " ...by demonstrating that migraine is eminently

treatable, and by accumulating knowledge about its biology, practitioners will

continue to evolve their interest in the subject. "

Neurology 2000;54:156-163.

http://neurology.medscape.com/reuters/prof/2000/01/01.11/cl01110k.html

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