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Safer Drug Developed for Migraine Treatment

Oral telcagepant marks a new era in migraine therapy

TUESDAY, Nov. 25 (HealthDay News) -- For moderate to severe migraine attacks, the calcitonin gene-related peptide (CGRP)-receptor antagonist telcagepant is safer compared with other drugs such as triptans, according to a report released online Nov. 25 in The Lancet.

In a randomized, placebo-controlled, double-blind, multicenter clinical trial spanning 81 European and U.S. sites, Tony W. Ho, M.D., of Merck Research Laboratories in North Wales, Pa., and colleagues studied the effect of oral telcagepant 150 mg (n=333) or 300 mg (n=354), zolmitriptan 5 mg (n=345) or placebo (n=348) in adults with moderate to severe migraine. The primary endpoints included pain freedom, pain relief, or absence of photophobia, phonophobia or nausea, two hours following therapy.

The findings suggest that all active treatments were more effective than placebo on the primary endpoints at two hours and on secondary endpoints of sustained pain freedom and total migraine freedom. Adverse events were reported for 32 percent taking placebo, 51 percent taking zolmitriptan, 37 percent taking telcagepant 300 mg, and 31 percent taking telcagepant 150 mg.

"One potential benefit of the new CGRP-receptor antagonist class of acute migraine treatments is the absence of vasoconstriction, a liability of the triptans, which may allow for the safe administration of telcagepant in patients with migraine with cardiovascular disease," the authors conclude. "Additional studies are also necessary to assess the long-term efficacy and safety profile of telcagepant in patients treating more than one migraine attack."

The study was funded by Merck and several study authors have financial relationships with the pharmaceutical industry.

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