Clinical studies of
triptans in the treatment of acute
migraines were comprehensively searched in the public databases. Pharmacodynamic models were established to describe the dose-effect and time-course of each kind of
triptan for the proportion of patients who became
pain free or had
pain relief.
RESULTS: A total of 92 articles involving 47,376 subjects were included in the analysis. After eliminating the placebo effect, oral
eletriptan (40 mg) had the highest efficacy among all oral drugs at the maximum approved dose, and the proportion of patients who became
pain free and had
pain relief were 30.9% and 37.9% at 2 h, respectively. However, oral
naratriptan (2.5 mg) had the lowest efficacy, and the proportion of patients who became
pain free and had
pain relief was 10.3% and 21.6% at 2 h, respectively. The efficacy of subcutaneous administration was significantly higher than that of
oral administration, and the efficacy of
nasal spray administration was comparable to that of
oral administration. Regarding the dose-effect, the efficacy of the
sumatriptan nasal spray significantly increased within the FDA (Food and Drug Administration)-approved dose range. When the dose was increased from 5 to 20 mg of
sumatriptan nasal spray, the proportion of patients who became
pain free and had
pain relief increased by 16.8% and 18.3% at 2 h, respectively. Regarding the time-course, the time of onset of subcutaneous
sumatriptan (6 mg) was the fastest, and the fraction of patients who were
pain free at 2 h accounted for 90.6% of that at 4 h.
CONCLUSIONS: