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document
Antimigraine efficacy of telcagepant based on patient 's historical triptan response . OBJECTIVE To evaluate whether the same or different patients respond to triptans and telcagepant . BACKGROUND Telcagepant is an oral calcitonin gene-related peptide receptor antagonist with acute antimigraine efficacy comparable to oral triptans . It is currently unknown whether migraine patients who can not be adequately helped with triptans might benefit from treatment with telcagepant . METHODS Post-hoc analysis of data from a randomized , controlled trial of telcagepant ( 150 mg , 300 mg ) zolmitriptan 5 mg , or placebo for a moderate/severe migraine . Responder rates were analyzed according to patients ' self-reported historical triptan response ( HTR ) : ( 1 ) good HTR ( N = 660 ) : response in 75-100 % of attacks ; ( 2 ) intermediate HTR ( N = 248 ) : response in 25-74 % of attacks ; ( 3 ) poor HTR/no use ( N = 407 ) : response in < 25 % of attacks , or patient did not take triptans . A limitation of the analysis is that the last subgroup comprised mainly ( 91 % ) patients who reported that they did not take triptans , but it was not known whether these patients were triptan-naïve or had previously used triptans and stopped taking them . RESULTS For zolmitriptan , 2-hour pain relief rates were higher in the good HTR subgroup ( 116/162 , 72 % ) than in the intermediate ( 29/62 , 47 % ) and poor/no use ( 44/111 , 40 % ) HTR subgroups . The 2-hour pain relief rates were similar across HTR subgroups for telcagepant 150 mg ( 48-58 % ) , 300 mg ( 52-58 % ) , and placebo ( 26-31 % ) . In the poor/no use HTR subgroup , more patients receiving telcagepant 300 mg ( 56/98 , 57.1 % ) had 2-hour pain relief than those receiving zolmitriptan ( 44/111 , 39.6 % ; odds ratio = 2.11 [ 95 % CI : 1.20,3.71 ] , P = .009 ) ; the percentage for telcagepant 150 mg ( 57/119 , 47.9 % ) was not significantly different from zolmitriptan ( odds ratio = 1.41 [ 95 % CI : 0.82 , 2.40 ] , P = .211 ) . CONCLUSIONS This suggests that different patients may respond to triptans or telcagepant 300 mg . Caution should be exercised in interpreting the results because of the post-hoc nature of the analysis ( clinical trial registry : NCT00442936 ) .
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Intervention_Pharmacological
telcagepant
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Intervention_Pharmacological
triptan
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Intervention_Pharmacological
triptans
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Intervention_Pharmacological
telcagepant
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Intervention_Pharmacological
Telcagepant
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Intervention_Physical
oral calcitonin gene-related peptide receptor
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Intervention_Pharmacological
oral triptans .
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Intervention_Pharmacological
triptans
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Intervention_Pharmacological
telcagepant
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Intervention_Pharmacological
telcagepant ( 150 mg , 300 mg ) zolmitriptan 5 mg , or placebo
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Intervention_Pharmacological
triptan
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Outcome_Other
Antimigraine efficacy
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Outcome_Physical
respond to triptans
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Outcome_Other
antimigraine efficacy
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Outcome_Physical
self-reported historical triptan response ( HTR ) :
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Participant_Condition
patients respond to triptans and telcagepant .
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Participant_Condition
the last subgroup comprised mainly ( 91 % ) patients who reported that they did not take triptans , but it was not known whether these patients were triptan-naïve or had previously used triptans and stopped taking them .