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NSAIDs Provide Acute Migraine Pain Relief

 

Nonsteroidal anti-inflammatory drugs (NSAIDs) can be highly efficacious in treating acute migraine attacks, a recent study suggests.

 

A team of researchers found that the majority of patients who used at least one type of NSAID for acute migraine treatment in the three months before the study experienced some form of pain relief.

 

The retrospective study included 741 individuals (604 women)—mean age of 40 years—who had a first visit for a migraine attack at the Center for the Study of Headache at the G. D’Annunzio University of Chieti in Italy between 2000 and 2009. The researchers found that 18% used ketoprofen, 17% used ibuprofen and 55% used nimesulide—which is not available in the United States. Of the study patients, 70% used more than one NSAID at a time. The use of triptans, a class of medication for treating acute migraines, was reported by 7.1% of the patients.

 

A team of researchers found that the majority of patients who used at least one type of NSAID for acute migraine treatment in the three months before the study experienced some form of pain relief.

The retrospective study included 741 individuals (604 women)—mean age of 40 years—who had a first visit for a migraine attack at the Center for the Study of Headache at the G. D’Annunzio University of Chieti in Italy between 2000 and 2009. The researchers found that 18% used ketoprofen, 17% used ibuprofen and 55% used nimesulide—which is not available in the United States. Of the study patients, 70% used more than one NSAID at a time. The use of triptans, a class of medication for treating acute migraines, was reported by 7.1% of the patients.

The rate of complete versus incomplete or total lack of efficacy was statistically significantly higher for nimesulide and ketoprofen (P<0.0001 for both) and ibuprofen (P<0.008).

 

“We can’t state whether NSAIDs should be preferred to other medications for acute migraine or vice versa because although NSAIDs are far less expensive, what really counts is the efficacy and side effects, and these are different for every patient,” said lead investigator Maria Adele Giamberardino, MD, associate professor of internal medicine at the G. D’Annunzio University of Chieti. “In any case, symptomatic treatment with NSAIDs or other drugs should run parallel with prophylactic treatment, when indicated, to reduce the number of attacks and thus use and abuse of the acute treatment drug.”

 

Dr. Giamberardino, also research director of the university’s Pathophysiology of Pain Laboratory, and head of the Center for Fibromyalgia and Musculoskeletal Pain and the Headache Center, added that the study is a part of a much larger analysis of NSAID use by migraine patients at her institution.

 

Stephen Silberstein, MD, professor of neurology and director of the Headache Center, Thomas Jefferson University, in Philadelphia, said he is “anxiously awaiting” the results from the complete study.

 

“The poster presented a retrospective analysis that just looked at people who had been taking NSAIDs. And if you ask the average person if the drugs they’re taking are good, they say yes. So these results just tell you that people keep taking the drugs they’re satisfied with,” said Dr. Silberstein.

 

Dr. Giamberardino‘s team is currently analyzing the data from the complete study. She said some patients stopped taking NSAIDs, but not because they didn’t work.

 

“Although I cannot provide you with the numbers, it appears that the vast majority of our patients found NSAIDs effective. The main reasons for discontinuation were not a lack of efficacy but either the occurrence of side effects—mostly gastritis—or the refusal by their family care physician to continue to prescribe the NSAIDs,” said Dr. Giamberardino in an email.

 

According to Dr. Giamberardino, most NSAIDs require a prescription in Italy. The findings were presented at the 2014 World Congress of Pain (abstract PT293).

—Rosemary Frei, MSc

 

Source: www.painmedicinenews.com