April 20, 2007

New treatment eases pounding pain of migraine

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Jan Lewis Brandes, M.D.

New treatment eases pounding pain of migraine

Neurology researchers have identified a new, more potent therapy to relieve the often-debilitating symptoms of migraine.

They found that combining two different types of treatment for migraine results in better symptom relief than taking either one of the medications individually.

Results of the studies involving nearly 3,000 migraine sufferers at 118 U.S. clinical centers were published recently in the Journal of the American Medical Association.

Migraine is a prevalent, painful disease manifested by attacks of severe headache and other associated symptoms, such as nausea, vomiting and sensitivity to light and sound. Approximately 29.5 million people in the United States suffer from migraines, according to the latest estimates from the Centers for Disease Control and Prevention.

While treatment advances have been made, results are still often unsatisfactory for many patients.

None of the currently available medications — taken alone — provide broad coverage of the multiple pathogenic processes in migraine, which is thought to involve multiple neural pathways.

Jan Lewis Brandes, M.D., assistant clinical professor of Neurology at Vanderbilt, and colleagues felt a multimechanism-targeted therapy might confer advantages over a single therapy.

The investigators evaluated the effectiveness and safety of treating migraine by combining the migraine medications sumatriptan (in the class of drugs known as triptans) and naproxen sodium (a nonsteroidal anti-inflammatory drug, or NSAID) compared with placebo and either of those drugs individually.

Patients involved in the two studies were diagnosed as having migraine fewer than 15 days per month, and received study treatment for a moderate or severe attack.

They found that the sumatriptan-naproxen sodium therapy was superior to sumatriptan monotherapy, naproxen sodium monotherapy and placebo in sustained pain-free response from 2-24 hours. The combined therapy was also effective at reducing light and sound sensitivity and nausea.

“A major benefit is that this therapy targets more than one migraine mechanism, so it shuts the migraine down rapidly and effectively,” Brandes said.

“And that's the key for migraine patients — once you're able to get them pain free, you're much more likely to keep them pain free.”

The suma-naproxen therapy Brandes and colleagues studied is currently being reviewed by the Food and Drug Administration, and could be approved sometime this summer.

It is intended for long-term, episodic use in treating the crushing symptoms of migraine. It is not intended for daily use, Brandes said.