Eletriptan vs. Sumatriptan (Imitrex - Imigran).

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Posted by drummer ( on January 18, 2000 at 06:21:24:

Our friend, Bob P posted a link to a new medication called Eletriptan yesterday. For those of you who may have missed that link; I have copy/pasted the article here. I also drafted an E-mail to Dr. Peter Goadsby asking him if he has used Eletriptan on any Cluster Headache patients and what forms, (pill, spray, injection) Eletriptan may come in. Dr. Goadsby’s response to my E-mail follows this article:

Eletriptan May Prove Superior to Sumatriptan

By Deborah Mitchell

WESTPORT, Jan 11 (Reuters Health) - Compared with sumatriptan, eletriptan appears to have a "...superior efficacy, onset of action and patient acceptability" for the treatment of acute migraine, a multicenter team reports in the January issue of Neurology.

Dr. P. J. Goadsby of The National Hospital for Neurology and Neurosurgery in London, UK, and colleagues conducted a phase II trial in which the safety and efficacy of three doses of eletriptan, 20 mg, 40 mg, or 80 mg, were compared with that of oral sumatriptan (100 mg) and placebo. The investigators evaluated 692 migraineurs who were randomized to one of these treatments for an acute attack. Dr. Goadsby's group found that "...significantly more patients receiving eletriptan (40 mg and 80 mg) reported headache improvement compared to patients receiving sumatriptan (100 mg) and placebo," according to a press release from the University College London Hospitals. In addition, as reported in the paper, "Headache-free rates at 2 hours were superior to placebo (6%) for both the 80-mg dose of eletriptan (37%) and the 40-mg dose (29%), with the 80-mg dose also being superior to sumatriptan (23%)." No serious drug-related effects were observed, and all treatments were considered well tolerated. However, a higher overall incidence of side effects was seen in the 80-mg eletriptan group compared with the other groups. The most frequent drug-related side effects in both treatment groups were asthenia, dizziness, somnolence and paresthesia. "This latest of the triptans is able to compete with the standard triptan on its own turf," Dr. Goadsby commented to Reuters Health. Using the standard 2-hour post-treatment response end-point, "...this is the first of the triptans that has been able to get itself head and shoulders above sumatriptan." "Eletriptan has more robust early time-point data than sumatriptan does," he continued. "Patients like the drug because it did tend to work quickly, and patients value rapid onset of action and efficacy pretty much above everything else." The results of phase III studies, which have also been successfully completed, are similar to these findings, he continued, and eletriptan is currently under review by the regulatory authorities in the UK and US. Dr. Goadsby also stressed that physicians need to think of migraine "...in terms of its biology and in terms of its disability." Eletriptan, along with other triptans should be viewed "...as another step in really being able to get on top of what can be a dreadful condition." "What we don't want to lose sight of is the endgame, which is to minimize disability due to migraine." He believes that differences in efficacy are less important than reducing the rate of undertreatment. "I'd like to see this kind of information in some way be a springboard to having more people treated better, rather than to argue about how to fine-tune those who already have treatment." Dr. Goadsby hopes that "...by demonstrating that migraine is eminently treatable, and by accumulating knowledge about its biology, practitioners will continue to evolve their interest in the subject."

Dr. Peter J. Goadsby,
Hi again,
I have E-mailed you in the past and asked for your opinion on several topics in regards to your Cluster Headache research. I've asked you things from Serotonin levels in my brain to theories about CH. Thank you for returning my E-mails and giving me your opinions. I've recently read an article about your research into Eletriptan. It is my understanding that Eletriptan is currently in a "pill" form. I have just aborted a Cluster attack with a 1/3 dose, (2mg) injection of Sumatriptan, (Imitrex/Imigran). It aborted my normally 1-hour unmedicated headache in 15 minutes. Have you performed any experiments with Eletriptan and Cluster Headache patients? Will Eletriptan be available in injections for Cluster Headache patients? Thank you for your time, Dave

There is no Eletriptan in cluster headache experience. The middle way will eventually be a nasal spray which might do what you want without injections. You will be glad to know that a needless injection of sumatriptan is also being developed, so things will get better.

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