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Selective serotonin 1F receptor agonist effective against acute migraine

מתוך medicontext.co.il

WESTPORT, CT (Reuters Health) – The serotonin receptor agonist LY334370, which targets the 5-HT-1F receptor, appears to be effective treatment for acute migraine, according to the results of a randomized trial reported in The Lancet for October 13. The authors explain that such selective agonists do not constrict arteries and should reduce the risk of cardiac ischemia.

Dr. David J. Goldstein from Lilly Research Laboratories, Indianapolis, the manufacture of LY334370, and colleagues randomly assigned 99 outpatients with moderate to severe migraine to placebo or LY334370 at 20 mg, 60 mg or 200 mg.

A sustained response with LY334370 was seen in 3 of 22 patients receiving 20 mg, 11 of 30 receiving 60 mg and in 11 of 21 who received 200mg compared with 2 of 26 who received placebo (p < 0.001). At 2 hours, none of the patients receiving 20 mg were pain free, while eight of those receiving 60 mg were pain free, as were eight of those receiving 200 mg of LY334370 (p = 0.001), the researchers report.

One patient receiving placebo had a sustained pain-free response compared with none of those receiving 20 mg, seven of those receiving 60 mg and seven of those receiving 200 mg of LY334370 (p = 0.002). "The rates of pain free and sustained pain free for LY334370 in this trial were similar, suggesting that once the headache is gone, it is unlikely to return," Dr. Goldstein's group points out.

Ten percent of the patients receiving LY334370 at 60 mg or 200 mg reported asthenia, dizziness, somnolence and paresthesia, the investigators note.

"This placebo-controlled study shows that 60 mg and 200 mg doses of LY334370 are effective in endings attacks of acute migraine. The 20 mg dose had no effect," Dr. Goldstein and colleagues conclude. They add that the findings suggest that acute migraine responds to 5-HT-1F receptor agonists, "which act through selective trigeminovascular neuronal inhibition, and which cause little vasoconstriction."

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