Migraine aura is a warning sign readily recognized by patients. From the onset of
aura it takes 30-60 min before the
headache phase starts. Administration of acute medication during
aura should provide sufficient time to achieve therapeutic plasma levels, counteracting the
headache. To test this hypothesis we evaluated the efficacy of
eletriptan 80 mg taken during
aura. Patients met International
Headache Society diagnostic criteria for
migraine with aura, with an attack frequency of at least one per month and with
aura occurring in > 50% of recent attacks. Of 123 patients randomized, 87 (71%) were treated with a double-blind, one attack, during the
aura phase before
headache, dose of either
eletriptan 80 mg (n = 43; 74% female; mean age, 40 years), or placebo (n = 44; 82% female; mean age, 40 years). The primary outcome measure was the proportion of patients not developing moderate-to-severe
headache within 6 h post-dose. There was no significant difference in the proportion of patients developing moderate-to-severe
headache on
eletriptan (61%) versus placebo (46%).
Eletriptan was well tolerated and did not prolong the
aura phase. Typical transient
triptan adverse events were observed; most were mild-to-moderate in intensity. This study confirms the findings of two studies showing that
triptans are ineffective but safe when given during the
migraine aura phrase.