Treatment of acute migraine with subcutaneous sumatriptan

• Published in: JAMA : the journal of the American Medical Association Vol. 265; no. 21; p. 2831
• Main Authors: Cady, R K, Wendt, J K, Kirchner, J R, Sargent, J D, Rothrock, J F, Skaggs, Jr, H
• Format: Journal Article
• Language: English
• Published: United States 05.06.1991
• Subjects: Acute Disease; Adult; Double-Blind Method; Female; Humans; Indoles - administration & dosage; Indoles - adverse effects; Indoles - therapeutic use; Injections, Subcutaneous; Male; Migraine Disorders - drug therapy; Sulfonamides - administration & dosage; Sulfonamides - adverse effects; Sulfonamides - therapeutic use; Sumatriptan; Vasoconstrictor Agents - administration & dosage; Vasoconstrictor Agents - adverse effects; Vasoconstrictor Agents - therapeutic use
• ISSN: 0098-7484
• DOI: 10.1001/jama.1991.03460210077033

Sumatriptan succinate, a 5-HT1D receptor agonist, constricts human cranial arteries. Two parallel-group trials for treatment of acute migraines were conducted in the United States. Adult patients were randomized and given either 6 mg of sumatriptan succinate subcutaneously (n = 734) or placebo (n = 370). At 1 hour, sumatriptan was significantly more effective than placebo in reducing moderate or severe headache pain to mild or no pain (70% vs 22%), in completely relieving headaches (49% vs 9%), and in improving clinical disability (76% vs 34%). Sumatriptan also reduced nausea and photophobia significantly better than placebo. Patients with residual migraines received another injection; those who had originally received sumatriptan received either a second active injection (n = 187) or placebo (n = 178), while those who had received placebo received a second placebo injection (n = 335). Statistical evidence for benefit of second sumatriptan injection is absent. Adverse events associated with sumatriptan were tingling, dizziness, warm-hot sensations, and injection-site reactions. Sumatriptan is effective and well tolerated in patients with acute migraine.