Early treatment with sumatriptan prevents PACAP38-induced migraine: A randomised clinical trial
Research output: Contribution to journal › Journal article › Research › peer-review
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).
Original language | English |
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Journal | Cephalalgia |
Volume | 41 |
Issue number | 6 |
Pages (from-to) | 731-748 |
Number of pages | 18 |
ISSN | 0333-1024 |
DOIs | |
Publication status | Published - 2021 |
Bibliographical note
Publisher Copyright:
© International Headache Society 2021.
- Blood vessels, headache, mast cell degranulation, PACAP isoforms, serotonin, triptans
Research areas
ID: 278501884