Sumatriptan (50 and 100 mg) in repeated migraine attacks: a patient preference study

Oral sumatriptan in 100-mg tablets is an effective and well tolerated treatment for the acute migraine attack. Since the launch of that dose, further studies have suggested good efficacy also for lower doses. This Italian multicentre study aimed at evaluating patient preference between the 50- and 100-mg does for acute treatment of migraine. Data on efficacy and safety are provided as secondary end points of this trial. The study design is on open basis: the patients treated their first 3 migraine attacks with 50 mg sumatriptan and then were able to choose whether to increase the dose to 100 mg or to continue with the initial treatment for the next 3 attacks. Two hundred one patients treated at least 3 attacks and 182 treated 6 attacks: 68% of the patients, after the third attack, preferred to continue with 50-mg sumatriptan tablets, while 32% preferred to switch to the 100-mg dose. In the first 3 attacks treated with 50 mg, 60% of patients improved at 2 hours and 72% at 4 hours after the first dose. In the set of patients that preferred to use 100 mg for the second block of 3 attacks (32%), the improvement at 2 and 4 hours after the dose was respectively 34% and 48%. Minor adverse events were reported by 15% of the patients. We conclude that less than one-third of patients treated with sumatriptan needs the 100-mg dose.