Although intranasal sumatriptan demonstrates superior headache relief over placebo in acute migraine attacks, administration of the agent is also associated with a 6-fold increased risk for taste disturbance, according to results of a recent systematic review and meta-analysis published in Neurological Sciences.

Researchers included data from 16 randomized controlled trials (n=5925). The overall effect-estimate demonstrated that intranasal sumatriptan was significantly superior to placebo for pain relief (risk ratio [RR] 1.70; 95% CI, 1.31-2.21; P <.0001) and headache relief (RR 1.58; 95% CI, 1.35-1.84; P <.00001) at 2 hours. Although sumatriptan was significantly more effective for headache relief at 30 minutes compared with placebo (RR 1.31; 95% CI, 1.08-1.59; P =.005), no statistically significant difference was observed between the 2 groups with respect to the overall RR of pain-free participants 30 minutes after treatment (RR 1.18; 95% CI, 0.49-2.88; P =.71).

Further analysis showed that although higher doses of sumatriptan resulted in shorter time to headache relief compared with placebo, they also correlated with a greater incidence of adverse events, notably taste disturbance (RR 6.87; 95% CI, 3.76-12.54; P <.00001).  


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Overall, the researchers concluded that the use of intranasal sumatriptan is an effective treatment for patients with acute migraine attacks; however, future investigations are needed to better understand differences in routes of administration and other therapies for migraine.

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Reference

Menshawy A, Ahmed H, Ismail A, et al. Intranasal sumatriptan for acute migraine attacks: a systematic review and meta-analysis [published online September 23, 2017]. Neurol Sci. doi:10.1007/s10072-017-3119-y