Sumatriptan is less effective in migraines with aura than those without aura, while dihydroergotamine (DHE) was similarly effective in both patients with and without aura. That is the conclusion from a review of patients in the sumatriptan/naratriptan aggregate patient database and a randomized, controlled trial of DHE.
Researchers examined pooled outcome data and found:
• 2-hour pain-free rates following 100 mg sumatriptan were significantly higher in patients treating attacks without aura than those with aura, at 32% versus 26%.
• 2-hour pain-free rates following DHE did not differ between migraines with or without aura, at 27% versus 29%.
The study authors suggest the differing responses to treatment may provide insight into the underlying mechanisms of migraines with and without aura, and may help to influence the choice of acute treatment for different types of migraine attacks.
Citation: Hansen JM, Goadsby PJ, Charles A. Reduced efficacy of sumatriptan in migraine with aura vs without aura. Neurology. 2015;84(18):1880-1885. doi:10.1212/WNL.0000000000001535.