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Zolmitriptan nasal spray may be beneficial in the treatment of migraines in adolescents, according to research presented at the 59th American Headache Society (AHS) Annual Scientific Meeting, held June 8-11, 2017, in Boston, Massachusetts.1
Paul Winner, DO, from Albert Einstein College of Medicine and Montefiore Headache Center, Bronx, New York, conducted a study to analyze the effect of patient age on the effectiveness of zolmitriptan nasal spray (ZNS) in adolescent migraine, using the subgroups of younger (between the age of 12 and 14 years) and older (between the age of 15 and 17 years) adolescents.
Dr Winner enrolled adolescents with an established diagnosis of migraine with or without aura in a randomized, double-blind, parallel-group study aiming for a primary outcome of pain-free status 2 hours following treatment. He randomly assigned 798 patients (61.8% female, mean age 14.4 years) — 407 in the younger age group and 391 in the older group — during a 30-day placebo run-in period to treat a single migraine attack with ZNS (5.0 mg, 2.5 mg, or 0.5 mg) or placebo (5:3:3:5 ratio) within 10 weeks of randomization. Participants also completed a 24-hour headache diary after migraine treatment.
In both the older and younger groups, treatment with ZNS 5 mg significantly increased the percentage of patients who were pain-free at the 2-hour posttreatment mark compared with placebo (29.4%, placebo: 14.0%; P <.05).
“The most commonly reported adverse event for ZNS was dysgeusia, reported in 6.5%, 6.2%, and 12.6% of patients using 0.5 mg, 2.5 mg, and 5 mg doses, respectively, vs 1.2% for placebo,” Dr Winner reported. But “ZNS 5 mg significantly improved pain-free status at 2 hours compared to placebo in both younger and older adolescent subgroups, suggesting utility in the treatment of adolescent migraines across age groups.”
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- Winner P. Efficacy of zolmitriptan nasal spray for the treatment of acute migraine in adolescents: subgroup analysis by age. Presented at: 59th AHS Annual Scientific Meeting, June 8-11, 2017, Boston, Massachusetts.