Cilostazol induced migraine does not respond to sumatriptan in a double blind trial
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Cilostazol induced migraine does not respond to sumatriptan in a double blind trial. / Falkenberg, Katrine; Dunga, Bára Óladóttir Á; Guo, Song; Ashina, Messoud; Olesen, Jes.
I: The Journal of Headache and Pain, Bind 19, 11, 2018.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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T1 - Cilostazol induced migraine does not respond to sumatriptan in a double blind trial
AU - Falkenberg, Katrine
AU - Dunga, Bára Óladóttir Á
AU - Guo, Song
AU - Ashina, Messoud
AU - Olesen, Jes
PY - 2018
Y1 - 2018
N2 - BACKGROUND: Cilostazol is an inhibitor of phosphodiesterase 3 and thus causes accumulation of cAMP. It induces migraine-like attacks in migraine patients. Whether the cilostazol model responds to sumatriptan in migraine patients and therefore is valid for testing of future anti-migraine medications has never been investigated.METHODS: In a cross-over study, 30 patients received cilostazol (200 mg p.o.) on two separate days each day followed by oral self-administered placebo or sumatriptan 50 mg. We recorded headache characteristics and associated symptoms using a questionnaire. The 30 participants were asked to subsequently treat their spontaneous attacks with sumatriptan (50 mg) or placebo in a double-blind cross-over design and 15 participants did so.RESULTS: Cilostazol induced headache with some migraine characteristics in all participants; 18 patients on the sumatriptan day and 19 patients on the placebo day fulfilled criteria for a migraine-like attack. The difference in median headache intensity between sumatriptan and placebo at 2 h was not significant (p = 0.09), but it was at 4 h (p = 0.017). During spontaneous attacks, the difference between placebo and sumatriptan was not significant at 2 h (p = 0.26), but it was highly significant at 4 h (p = 0.006).CONCLUSION: The cilostazol model in migraine patients could not be validated by a sufficient sumatriptan response. The model may perhaps respond to new drugs that act intracellularly or directly on ion channels.TRIAL REGISTRATION: The study is registered on clinicaltrials.gov ( NCT02486276 ).
AB - BACKGROUND: Cilostazol is an inhibitor of phosphodiesterase 3 and thus causes accumulation of cAMP. It induces migraine-like attacks in migraine patients. Whether the cilostazol model responds to sumatriptan in migraine patients and therefore is valid for testing of future anti-migraine medications has never been investigated.METHODS: In a cross-over study, 30 patients received cilostazol (200 mg p.o.) on two separate days each day followed by oral self-administered placebo or sumatriptan 50 mg. We recorded headache characteristics and associated symptoms using a questionnaire. The 30 participants were asked to subsequently treat their spontaneous attacks with sumatriptan (50 mg) or placebo in a double-blind cross-over design and 15 participants did so.RESULTS: Cilostazol induced headache with some migraine characteristics in all participants; 18 patients on the sumatriptan day and 19 patients on the placebo day fulfilled criteria for a migraine-like attack. The difference in median headache intensity between sumatriptan and placebo at 2 h was not significant (p = 0.09), but it was at 4 h (p = 0.017). During spontaneous attacks, the difference between placebo and sumatriptan was not significant at 2 h (p = 0.26), but it was highly significant at 4 h (p = 0.006).CONCLUSION: The cilostazol model in migraine patients could not be validated by a sufficient sumatriptan response. The model may perhaps respond to new drugs that act intracellularly or directly on ion channels.TRIAL REGISTRATION: The study is registered on clinicaltrials.gov ( NCT02486276 ).
KW - Adult
KW - Cilostazol
KW - Cross-Over Studies
KW - Cyclic AMP
KW - Double-Blind Method
KW - Female
KW - Humans
KW - Male
KW - Middle Aged
KW - Migraine Disorders/chemically induced
KW - Models, Neurological
KW - Phosphodiesterase 3 Inhibitors/adverse effects
KW - Serotonin 5-HT1 Receptor Agonists/therapeutic use
KW - Sumatriptan/therapeutic use
KW - Surveys and Questionnaires
KW - Tetrazoles/adverse effects
KW - Treatment Failure
KW - Young Adult
U2 - 10.1186/s10194-018-0841-7
DO - 10.1186/s10194-018-0841-7
M3 - Journal article
C2 - 29396788
VL - 19
JO - Journal of Headache and Pain
JF - Journal of Headache and Pain
SN - 1129-2369
M1 - 11
ER -
ID: 216351299