Efficacy and safety of acetaminophen, aspirin, and caffeine in alleviating migraine headache pain: three double-blind, randomized, placebo-controlled trials.
Abstract | OBJECTIVE: DESIGN: Three double-blind, randomized, parallel-group, single-dose, placebo-controlled studies. SETTING: Private practice, referral centers, and general community. PATIENTS: Migraineurs with moderate or severe headache pain who met International Headache Society diagnostic criteria for migraine with aura or without aura. The most severely disabled segment of migraineurs, including those whose attacks usually required bed rest, or who vomited 20% or more of the time, were excluded. Of the 1357 enrolled patients, 1250 took study medication and 1220 were included in the efficacy-evaluable data set. INTERVENTION: MAIN OUTCOME MEASURES:
Pain intensity difference from baseline; percentage of patients with pain reduced to mild or none. RESULTS: Significantly greater reductions in migraine headache pain intensity 1 to 6 hours after dose were seen in patients taking the acetaminophen, aspirin, and caffeine combination than in those taking placebo in each of the 3 studies. Pain intensity was reduced to mild or none 2 hours after dose in 59.3% of the 602 drug-treated patients compared with 32.8% of the 618 placebo-treated patients (P< .001; 95% confidence interval [CI], 55%-63% for drug, 29%-37% for placebo); at 6 hours after dose, 79% vs 52%, respectively, had pain reduced to mild or none (P<.001; 95% CI, 75%-82% vs 48%-56%). In addition, by 6 hours after dose, 50.8% of the drug-treated patients were pain free compared with 23.5% of the placebo-treated patients (P<.001; 95% CI, 47%-55% for drug, 20%-27% for placebo). Other migraine headache characteristics, such as nausea, photophobia, phonophobia, and functional disability, were significantly improved 2 to 6 hours after treatment with the acetaminophen, aspirin, and caffeine combination compared with placebo (P< or =.01). CONCLUSIONS:
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Authors | R B Lipton, W F Stewart, R E Ryan Jr, J Saper, S Silberstein, F Sheftell |
Journal | Archives of neurology
(Arch Neurol)
Vol. 55
Issue 2
Pg. 210-7
(Feb 1998)
ISSN: 0003-9942 [Print] United States |
PMID | 9482363
(Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
- Analgesics
- Acetaminophen
- Caffeine
- Aspirin
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Topics |
- Acetaminophen
(therapeutic use)
- Adult
- Analgesics
(therapeutic use)
- Aspirin
(therapeutic use)
- Caffeine
(therapeutic use)
- Double-Blind Method
- Drug Therapy, Combination
- Female
- Humans
- Male
- Migraine Disorders
(diagnosis, drug therapy)
- Pain Measurement
- Severity of Illness Index
- Treatment Outcome
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