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African Journal of Neurological Sciences

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Effectiveness of Sumatriptan for Acute Treatment of Migraine Headache in an African Population (English)

OA Oluwole Steven, S.A. Bwala, A.C. Nwabueze, O. Davies Abiola

Abstract


Background

The triptans are currently the drugs of choice for acute treatment of migraine. Although there are several newer triptans, sumatriptan that was first introduced into clinical practice is still preferred to newer triptans by subjects in several clinical trials.

Objective

This study was conducted to determine the effectiveness of sumatriptan in an African population where triptans have not been introduced.

Methods

Subjects were recruited consecutively in three large teaching hospitals that are located in ethno-geographically different regions in Nigeria. Migraine headaches, which were classified using the criteria of the International Headache Society, were rated on visual analogue scale, while associated symptoms of migraine were rated on ordinal scale. Ratings of headaches and of associated symptoms before and four hours after 50 mg sumatriptan dose were compared using non-parametric tests.

Results

42 subjects, 11 males and 31 females, completed the study. 11 (26 %) subjects had migraine with aura, while 31 (74 %) subjects had migraine without aura. Before treatment headache was rated 0 –3 by no subject, 4 – 7 by 20 subjects, and 8 –10 by 22 subjects, but after treatment headache was rated 0 – 3 by 30 subjects, 4 – 7 by 7 subjects, and 8 – 10 by 5 subjects (P < 0.0001). Before treatment, 15 (36 %) subjects had nausea or vomiting, 23 (55 %) subjects had photophobia or phonophobia, and 36 (86 %) subjects had severe impairment of activity. Photophobia and phonophobia were reduced significantly (P < 0.0001), impairment of activity was reduced significantly (P = 0.02), but the proportion of subjects with nausea and vomiting did not change significantly (P > 0.05). Severity of headache, presence of associated symptoms, and impairment of activity were not associated with relief of headache.

Conclusion

Sumatriptan is effective to relieve the headache and the associated symptoms of migraine, and to induce early return to activity in this study population. Sumatriptan was well tolerated without serious clinical adverse effects.
Résumé


Introduction

Les triptans représentent actuellement le traitement de choix des migraines. Bien qu\'il y ait plusieurs types de triptans, le sumatriptan qui fut le premier a être introduit sur lemarché, a la faveur des prescripteurs.

Objectif

L\'objetif du travail présenté est d\'étudier l\'effet du sumatriptan sur une population africaine.

Methodes

Les sujets ont été recrutés consécutivement dans 3 hôpitaux universitaires situés dans différents zones géographiques du Nigéria. La classification répondait aux critères de l\' International Headache Society . L\'évaluation des migraines a été réalisée avant puis 4 heures après la prise de 50 mg de sumatriptan.

Résultats

42 sujets, 11 de sexe masculin et 31 de sexe féminin composaient le groupe d\'étude. 11 (26%) présentaient une migraine avec aura, tandis que 31 (74%) signalaient une absence d\'aura.Avant le traitement les migraines se répartissaient selon les scores suivants : 0 - 3, 4-7 20 patients ; 8 - 10, 22 patients. Après traitement, l\'évaluation était la suivante : 0 - 3, 30 patients ; 4 - 7, 7 patients ; 8 - 10, 5 patients ( P < 0.0001). Avant le traitement, 15 (36%) patients présentaient des nausées et des vomissements, 23 (55%) se plaignaient de photophobie et de phonophobie, et 36% (86%) subissaient un gêne fonctionnelle importante. Les photophobies et phonophobie étaient réduites significativement ( P = 0.02), mais la proportion de sujets souffrant de nausées et vomissements était inchangée (P > 0.05). La sévérité des crises, la présence de signes associées, et la perturbation des activités sociales n\'étaient pas correlées au soulagement des douleurs.

Conclusion

Le sumatriptan a un effet bénéfique sur les crises migraineuses et les signes associés et autorise un retour rapide aux activités sociales dans la population africaine étudiée. Le sumatriptan est bien toléré sans effet secondaire significatif.


(Af. J. of Neurological Sciences: 2003 22(2))



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