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Early treatment with sumatriptan prevents PACAP38-induced migraine: A randomised clinical trial

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

DOI

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OBJECTIVE: To determine whether early treatment with sumatriptan can prevent PACAP38-induced migraine attacks.

METHODS: A total of 37 patients with migraine without aura were enrolled between July 2018 to December 2019. All patients received an intravenous infusion of 10 picomole/kg/min of PACAP38 over 20 min followed by an intravenous infusion of 4 mg sumatriptan or placebo over 10 min on two study days in a randomised, double-blind, placebo-controlled, crossover study.

RESULTS: Of 37 patients enrolled, 26 (70.3%) completed the study and were included in analyses. Of the 26 patients, four (15%) developed a PACAP38-induced migraine attack on sumatriptan and 11 patients (42%) on placebo (p = 0.016). There were no differences in area under the curve for headache intensity between sumatriptan (mean AUC 532) and placebo (mean AUC 779) (p = 0.35). Sumatriptan significantly constricted the PACAP38-dilated superficial temporal artery immediately after infusion (T30) compared with infusion of placebo (p < 0.001).Conclusions and relevance: Early treatment with intravenously administered sumatriptan prevented PACAP38-induced migraine. Prevention of migraine attacks was associated with vasoconstriction by sumatriptan in the earliest phases of PACAP provocation. These results suggest that sumatriptan prevents PACAP38-induced migraine by modulation of nociceptive transmission within the trigeminovascular system.Trial Registration: ClinicalTrials.gov (NCT03881644).

OriginalsprogEngelsk
TidsskriftCephalalgia : an international journal of headache
Vol/bind41
Udgave nummer6
Sider (fra-til)731-748
Antal sider18
ISSN0333-1024
DOI
StatusUdgivet - maj 2021

Bibliografisk note

Funding Information:
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The study was supported by grants from Novo Nordisk Foundation (NNF170C0029698), Augustinus Foundation (17-2523) and Lundbeck Foundation. JH is supported from the Danish Biotechnology Center for Cellular Communication.

ID: 65608247