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Excellent Tolerability But Relatively Low Initial Clinical Efficacy of Telcagepant in Migraine
Author(s) -
TfeltHansen Peer
Publication year - 2011
Publication title -
headache: the journal of head and face pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.14
H-Index - 119
eISSN - 1526-4610
pISSN - 0017-8748
DOI - 10.1111/j.1526-4610.2010.01797.x
Subject(s) - tolerability , migraine , rizatriptan , medicine , anesthesia , zolmitriptan , calcitonin gene related peptide , randomized controlled trial , adverse effect , sumatriptan , receptor , neuropeptide , agonist
( Headache 2011;51:118‐123) In 3 randomized clinical trials (n = 1585) the calcitonin gene‐related peptide antagonist telcagepant 300 mg orally had an incidence of adverse events similar to placebo when used in the acute treatment of migraine. Telcagepant, thus, has excellent tolerability in migraine. Only a quarter (26%) (334/1307) of patients were, however, pain free after 2 hours, while 56% (729/1297) of patients had pain relief at 2 hours. Telcagepant 300 mg in one randomized clinical trial was equipotent to zolmitriptan 5 mg. Based on results from a meta‐analysis, rizatriptan 10 mg (41%) and almotriptan (35%) seem superior to telcagepant (26%) for pain free at 2 hours whereas rizatriptan 10 mg (25%) showed no difference from telcagepant 300 mg (19 %) for sustained pain free (2‐24 hours). The introduction of calcitonin gene‐related peptide receptor antagonism in the acute treatment of migraine is a major step forward but so far mostly because of its specific mode of action and excellent tolerability.