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DOI: 10.1055/s-2007-986223
© Georg Thieme Verlag KG Stuttgart · New York
Migränetherapie mit Almotriptan
Therapy for Migraine with AlmotriptanePublication History
Publication Date:
29 October 2007 (online)
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Zusammenfassung
Triptane sind selektive 5-HT1B- und 5-HT1D-Rezeptoragonisten, die in der Akutbehandlung der Migräne eine wichtige Rolle spielen. Mittlerweile stehen sieben Triptane zur Verfügung, die sich alle als sicher und verträglich erwiesen haben. Bei Almotriptan handelt es sich um eines der neueren Präparate, welches in zahlreichen Studien zur Dosisfindung, Effektivität und Verträglichkeit untersucht wurde. Almotriptan zeichnet sich durch ein Wirkungsprofil aus, das mit Sumatriptan hinsichtlich der Schmerzlinderung, vollständigen Schmerzfreiheit und Wiederkehrkopfschmerzrate vergleichbar ist. Dabei liegt die Ansprechrate 2 Stunden nach Einnahme von Almotriptan zwischen 60 - 70 %. In Bezug auf die Verträglichkeit scheint eine Therapie mit Almotriptan einer Behandlung mit anderen Triptanen ebenbürtig und in einzelnen Belangen sogar überlegen zu sein. Die Nebenwirkungsrate von Almotriptan ist mit der Einnahme von Plazebo vergleichbar und betrifft dabei sowohl zentrale Symptome (Schwindel, Müdigkeit u. a.) wie auch „Brustsymptome” (Palpitationen, thorakales Engegefühl).
Abstract
Triptanes are selective 5-HT1B- and 5-HT1D-receptor agonists that play a key role in the acute management of migraine. Meanwhile we have seven triptanes at hand - all of them proven to be safe and tolerable. Almotriptane is one of the more recent preparations which has been scrutinized as to proper dosage, efficiency and tolerance in a great number of studies. With regard to alleviation of pain, complete analgesia and the rate of relapsing headaches, the profile of action displayed by almotriptane is commensurate with those of sumatriptane. The response rate of almotriptane two hours after intake varies between 60 and 70 %. As to tolerance, it would seem that almotriptane is equivalent, in some issues even superior, to the other triptanes in use. The rate of adverse effects incurred with almotriptane equals that of placebo concerning central symptoms (dizziness, fatigue etc.) that is, as well as „chest symptoms” (palpitations, thoracic constriction).
Schlüsselwörter
Migräne - Almotriptan - unerwünschte Wirkungen
Key words
migraine - almotriptane - side effects
Literatur
- 1 Bou J, Domenech T, Puig J. et al . Pharmacological characterization of almotriptan: an indolic 5-HT receptor agonist for the treatment of migraine. Eur J Pharmacol. 2000; 410 33-41
- 2 Goadsby P J, Lipton R B, Ferrari M D. Migraine-current understanding and treatment. N Engl J Med. 2002; 346 257-270
- 3 Tfelt-Hansen P, De Vries P, Saxena P R. Triptans in migraine. A comparative review of pharmacology, pharmacokinetics and efficacy. Drugs. 2000; 60 1259-1287
- 4 Dahlöf C G, Dodick D, Dowson A J, Pascual J. How does almotriptan compare with other triptanes? A review of data from placebo-controlled clinical trials. Headache. 2002; 42 99-113
- 5 Cabarrocas X, Warrington S J, Jansat J M. et al . Pharmacokinetics and tolerability of oral almotriptan in the elderly (Abstract). Cephalalgia. 1999; 19 363
- 6 Cabarrocas X, Jansat J M, Ferrer P, Luria X. Pharmacokinetics of oral almotriptan during and outside a migraine attack (Abstract). Cephalalgia. 2000; 20 417
- 7 Garcia E, Cabarrocas X, Jansat J M. A clinical trial to determine the lack of food interaction on the bioavailability of almotriptan, a new 5-HT1B/1D agonist, in healthy volunteers (Abstract). Headache. 1998; 38 376
- 8 Jansat J M, Costa J, Salva P. et al . Absolute bioavailability, pharmacokinetics, and urinary excretion of the novel antimigraine agent almotriptan in healthy male volunteers. J Clin Pharmacol. 2002; 42 1303-1310
- 9 Fachinformation. Almogran® 12,5 mg. Stand April 2007.
- 10 Dahlöf C G, Pascual J, Dodick D W, Dowson A J. Efficacy, speed of action and tolerability of almotriptan in the acute treatment of migraine: pooled individual patient data from for randomized, double-blind, placebo-controlled clinical trials. Cephalalgia. 2006; 26 400-408
- 11 Dahlöf C G, Tfelt-Hansen M D, Massiou H, Fazekas M D. Dose finding, placebo-controlled study of oral almotriptan in the acute treatment of migraine. Neurology. 2001; 57 1811-1817
- 12 Dowson A J, Massiou H, Lainez J M, Cabarrocas X. Almotriptan is an effective and well-tolerated treatment for migraine pain: results of a randomized, double-blind, placebo-controlled clinical trial. Cephalalgia. 2002; 22 453-461
- 13 Martinez E, Cabarroccas X, Peris F. et al . Meta-analysis of the efficacy and safety of almotriptan in the treatment of migraine (Abstract). Cephalalgia. 1999; 19 362
- 14 Mathew N, Finlayson G, Smith T. et al, on behalf of the AEGIS Investigator Study Group . Early Intervention With Almotriptan: Results of the AEGIS Trial (AXERT® Early Migraine Intervention Study). Headache. 2007; 47 189-198
- 15 Pascual J, Falk R M, Piessens F. et al . Consistent efficacy and tolerability of almotriptan in the acute treatment of multiple migraine attacks: results of a large, randomized, double-blind, placebo-controlled study. Cephalalgia. 2000; 20 588-596
- 16 Pascual J, Lainez J M, Leira R. et al . Almotriptan in the treatment of migraine attacks in clinical practice: results of the TEA 2000 observational study. Neurologia. 2003; 18 7-17
- 17 Pascual J, Tranche S, Leira R. et al . Almotriptan in clinical practice: experience in primary care vs. neurology setting. Headache. 2003; 43 525
- 18 Diener H C. Satisfaction with almotriptan 12,5 mg for treating multiple migraine attacks: An observational study in routine clinical settings in Germany. Headache. 2004; 44 470-471
- 19 Lainez M J, Galvan J, Heras J, Vila C. Crossover, double-blind clinical trial comparing almotriptan and ergotamine plus caffeine for acute migraine therapy. Eur J Neurol. 2007; 14 269-275
- 20 Diener H C, Gendolla A, Gebert I, Beneke M. Almotriptan in migraine patients who respond poorly to oral sumatriptan: a double-blind, randomized trial. Headache. 2005; 45 1-9
- 21 Goadsby P J, Vila C. „Act When Mild” (AWM) study: early vs. non-early almotriptan intervention in migraine; presented at the 16th Migraine Trust International Symposium (MTIS) in London, on 20 September 2006.
- 22 Mathew N. A long-term open-label study of oral almotriptan 12,5 mg for the treatment of acute migraine attacks. Headache. 2002; 42 32-40
- 23 Pascual J, Falk R, Docekal R. et al . Tolerability and efficacy of almotriptan in the long-term treatment of migraine. Eur Neurol. 2001; 45 206-213
- 24 Mathew N. Early intervention with almotriptan improves sustained pain-free response in acute migraine. Headache. 2003; 43 1075-1079
- 25 Pascual J, Cabarrocas X. Within-patient early vs delayed treatment of migraine attacks with almotriptan: The sooner the better. Headache. 2002; 42 28-31
- 26 Diener H C, Landen H, Stauch K. Almotriptan in der Routine-Behandlung akuter Migräneattacken: Eine Post-Marketing-Studie mit 899 Patienten. Nervenheilkunde. 2003; 22 365-368
- 27 Dodick D W. Oral almotriptan in the treatment of migraine: safety and tolerability. Headache. 2001; 41 449-455
- 28 Dodick D W, Martin V. Triptans and CNS side-effects: pharmacokinetic and metabolic mechanisms. Cephalalgia. 2004; 24 417-424
- 29 Massiou H, Pradalier A, Donnet A. et al . Evaluation of efficacy, tolerability, and treatment satisfaction with almotriptan in 3 consecutive migraine attacks. The migraine-satisfaction with treatment: reality with Almotriptan study. Eur Neurol. 2006; 55 198-203
- 30 Ferrari M D, Roon K I, Lipton R B. et al . Oral triptans (serotonin 5-HT1B/1Dagonists) in acute migraine treatment: A meta-analysis of 53 trials. Lancet. 2001; 358 1668-1675
- 31 Ferrari M D, Goadsby P J, Roon K I, Lipton R B. Triptans (serotonin 5-HT1B/1Dagonists) in migraine: Detailed results and methods of a meta-analysis of 53 trials. Cephalalgia. 2002; 22 633-658
- 32 Cabarrocas X, Zayas J M, Suris M. on behalf of the Almotriptan Oral Study Group . Equivalent efficacy of oral almotriptan, a new 5-HT1B1D agonist compared with sumatriptan 100 mg. Headache. 1998; 38 377-378
- 33 Keam S J, Goa K L, Figitt D P. Almotriptan. A review of its use in migraine. Drugs. 2002; 62 387-414
- 34 Goadsby P J, Massiou H, Pascual J. et al . Almotriptan and zolmitriptan in the acute treatment of migraine. Acta Neurol Scand. 2007; 115 34-40
- 35 Gendolla A. Klinisches Profil und praktischer Einsatz von Almotriptan. Cephalalgia. 2004; 24 16-23
- 36 Anon X. Almogran (almotriptan maleate) tablets. Summary of Product Characteristics. 2003
- 37 Cabarrocas X, Salva M. Almotriptan has no pharmacokinetic/pharmacodynamic interaction with ethanol (Abstract). Cephalalgia. 2002; 22 605
- 38 Cabarrocas X, Macher J P. Lack of pharmacokinetic interaction between almotriptan and oral contraceptives: a double-blind, placebo-controlled, crossover study in healthy female volunteers (Abstract). Cephalalgia. 2003; 23 715
Dr. med. Svenja Filz
Fachbereich Neurologie, Deutsche Klinik für Diagnostik
Aukammallee 33
65191 Wiesbaden
Email: filz.neuro@dkd-wiesbaden.de