The Impact of Allodynia on the Efficacy of Almotriptan When Given Early in Migraine: Data From the "Act When Mild" Study

S. Diaz-Insa*, P. J. Goadsby, G. Zanchin, J. Fortea, M. Falques, C. Vila

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

16 Citations (Scopus)

Abstract

The objective of this study was to evaluate the impact of allodynia on treatment outcomes in the patients with acute migraine treated in the "Act when Mild" (AwM) study. AwM, a randomized placebo-controlled trial, studied almotriptan 12.5 mg in the early treatment (within 1 hr) of acute migraine when the pain was still mild, and investigated clinical outcomes in the presence or absence of allodynia, which was prospectively recorded using patient questionnaires. Of the total population, 39% (n = 404) reported allodynia that did not alter the efficacy of almotriptan administered for early/mild pain in terms of 2-hr pain-free rates (53.9% for allodynic patients vs. 52.5% for nonallodynic patients). Similarly, sustained pain-free rates were 47.2% versus 45.5%, and migraine duration 1.40 versus 1.54 hr, respectively. However, allodynia impaired the effectiveness of almotriptan in the patients with moderate/severe pain in terms of longer migraine duration, fewer patients achieving pain-free status, and more requiring rescue medication. In conclusion, the lack of effect of allodynia on the efficacy of almotriptan given for early/mild migraine pain might help explain the improved outcomes associated with the early-treatment strategy in AwM. Moreover, the data suggest that pain intensity is the main driver of triptan response, and not the presence or absence of allodynia.

Original languageEnglish
Pages (from-to)655-661
Number of pages7
JournalInternational journal of neuroscience
Volume121
Issue number12
DOIs
Publication statusPublished - Dec 2011

Keywords

  • acute migraine
  • almotriptan
  • Early treatment
  • headache
  • triptans
  • EARLY INTERVENTION
  • CUTANEOUS ALLODYNIA
  • AEGIS TRIAL
  • PAIN
  • HEADACHE
  • NEURONS
  • ATTACKS
  • PLACEBO
  • BRUSH

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