Sumatriptan Less Effective for Migraine When Aura Is Present

To investigate whether migraine treatment efficacy is altered by the presence of aura, either with the treated attack or historically, researchers retrospectively assessed pooled outcome data from 21 randomized, double-blind, placebo-controlled trials of sumatriptan 100 mg. The primary outcome was the rate of pain freedom at 2 hours. The authors performed a similar analysis using data from a single large, multicenter, randomized controlled trial of investigational orally inhaled dihydroergotamine.

Sumatriptan resulted in pain freedom for 32% of 1721 attacks without aura, compared with 24% of 847 attacks with aura (P<0.001). Therapeutic gain (response rate in treatment group minus response rate in placebo group) was 23% for attacks without au…