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Review: several drugs, especially triptans, are effective for pain relief in acute migraine

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 QUESTION: In patients with acute migraine, are pharmacological treatments better than placebo for short and long term pain relief?

Data sources

Studies in any language were identified by searching Medline (1966–2000), EMBASE/Excerpta Medica (1980–2000), the Cochrane Library, and the Oxford Pain Relief Database. Pfizer Inc. was contacted for data on all randomised controlled trials (RCTs) of eletriptan.

Study selection

Studies were selected if they were double-blind, placebo-controlled RCTs of pharmacological treatment for acute migraine (International Headache Society diagnostic criteria for migraine with or without aura) in adults. Other inclusion criteria were single migraine attack, single-dose treatment at standard doses, baseline pain of moderate or severe intensity, and dichotomous or percentage data for ≥1 efficacy outcome.

Data extraction

Studies were read independently by 2 reviewers and assigned a quality score. Data were extracted on study design, number of patients, dosing regimens, and timing or type of rescue medication. Outcomes were headache relief at 1 and 2 hours, freedom from …

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Footnotes

  • Sources of funding: Pain Relief Funds and Pfizer UK, Ltd.

  • For correspondence: Dr R A Moore, Oxford Radcliffe Hospital, Oxford, UK. Email andrew.moore{at}pru.ox.ac.uk.