Robert E. Ryan

Crossover Comparison of Rizatriptan 5 mg and 10 mg Versus Sumatriptan 25 mg and 50 mg in Migraine

Rizatriptan is a selective 5‐HT1B/1D receptor agonist with rapid oral absorption and early onset of action in the acute treatment of migraine. This double‐blind, placebo‐controlled, crossover study compared rizatriptan 5 mg versus sumatriptan 25 mg, and rizatriptan 10 mg versus sumatriptan 50 mg. A total of 1329 patients were allocated to one of five groups for treatment of two attacks: rizatriptan 5 mg/sumatriptan 25 mg; sumatriptan 25 mg/rizatriptan 5 mg; rizatriptan 10 mg/sumatriptan 50 mg; sumatriptan 50 mg/rizatriptan 10 mg; placebo/placebo. For each attack, patients rated headache severity, presence of associated symptoms, and functional disability prior to dosing and at intervals through 4 hours thereafter. Patients also rated their satisfaction with medication. Rizatriptan 5 mg and 10 mg provided faster relief of headache pain and greater relief of migraine symptoms than the 25‐mg and 50‐mg doses of sumatriptan, respectively. The response to rizatriptan was better than sumatriptan on additional measures including functional disability and satisfaction with medication. All active treatments were highly effective compared to placebo and acted as early as 30 minutes after dosing. All active treatments were well‐tolerated and showed comparable safety profiles.

Acetaminophen, Aspirin, and Caffeine in Combination Versus Ibuprofen for Acute Migraine: Results From a Multicenter, Double-Blind, Randomized, Parallel-Group, Single-Dose, Placebo-Controlled Study

Objective.—Compare the effectiveness of a combination analgesic containing acetaminophen, aspirin, and caffeine to that of ibuprofen in the treatment of migraine.

Clinical Efficacy of Frovatriptan: Placebo‐Controlled Studies

Objective.—To confirm the clinical efficacy of frovatriptan 2.5 mg.

A controlled study of the effect of oral contraceptives on migraine.

SYNOPSIS

Dose Range‐Finding Studies With Frovatriptan in the Acute Treatment of Migraine

Objective.—To determine the optimum dose of frovatriptan for the acute treatment of migraine.

Efficacy, safety, and tolerability of oral eletriptan for treatment of acute migraine: a multicenter, double-blind, placebo-controlled study conducted in the United States.

Objective.—To investigate the efficacy, consistency, safety, and tolerability of oral eletriptan in the acute treatment of three migraine attacks.

Nadolol: Its use in the Prophylactic Treatment of Migraine

SYNOPSIS

Comparative study of nadolol and propranolol in prophylactic treatment of migraine

Forty-eight patients (13 men and 35 women) took part in a double-blind randomized study. All patients received a placebo daily for 4 weeks (period A), at the end of which the frequency and severity of headaches experienced by each patient were assessed. Patients then received an active drug for 12 weeks (period B). Sixteen patients received nadolol, 80 mg/day; 16 received nadolol, 160 mg/day; and 16 received propranolol, 160 mg/day. The frequency and severity of headaches in the three groups were tabulated at the end of period B, as were the side effects. Only three subjects dropped out during the study, and one of these needed abdominal surgery. All three groups reported improvement, the most noticeable being in those patients who received 80 mg of nadolol daily.

A double-blind clinical evaluation of bromelains in the treatment of acute sinusitis.

THE BROMELAINS in particular have demonstrated a number of properties which would appear useful in the adjunctive treatment of sinusitis. From a representative sampling of the accumulated literature1-4, evidence has been presented which reflects an ability of the bromelains to resolve inflammation, control edema, digest protein, modify tissue permeability and, as has also been suggested, to indirectly mediate vasodilation5-6. Generally, these observations tend to support the recently proposed concept of inflammation7 and further clarify the role of the bromelains in inflammation. This concept maintains that during the inflammatory reaction, plasma proteins and fluids exude into the intravascular spaces from the blood vessels, and subsequent polymerization of these proteins increase the viscosity of exudates; additionally, the fibrinogen of the plasma is converted into a soft, partially-polymerized fibrin which occludes the pores of the vessels. Edema results. By direct action, and by a multiplicity of actions initiated by the bromelains, and involving other enzyme systems, proteolytic depolymerization reactions occur which reduce the viscosity of the inflammatory exudates and lyse the fibrin clots of the capillary spaces and lumens of the vessels. As a consequence, permeability is increased, drainage is facilitated, and biologic continuity is restored.

Immunoglobulin, complement, and immune complex levels during a migraine attack.

SYNOPSIS