Allodynia-Associated Symptoms, Pain Intensity and Time to Treatment: Predicting Treatment Response in Acute Migraine Intervention

Objective.— To evaluate the relationship between treatment outcomes and allodynia‐associated symptoms (AAS) at the time of treatment with almotriptan. Methods.— Analyses were performed with data collected prospectively from patients in 2 recently completed early intervention trials, AXERT® Early miGraine Intervention Study (AEGIS) and AXERT® 12.5 mg time vs Intensity Migraine Study (AIMS): 2‐hour pain free, 2‐hour pain relief (AEGIS only), sustained pain free (SPF), use of rescue medication, and median headache duration (AIMS only), in the presence and absence of pretreatment AAS, which was determined by responses to a questionnaire. Analyses were conducted to evaluate possible prognostic variables. Results.— The presence of pretreatment AAS did not have a significant effect on 2‐hour pain‐free, 2‐hour pain‐relief or SPF rates, use of rescue medication, or headache duration. Significant factors for most favorable outcomes (greater 2‐hour pain‐free, 2‐hour pain‐relief and SPF rates, less use of rescue medication, and shorter headache duration) included treatment with almotriptan 12.5 mg, treatment of mild or moderate headache pain, and treatment within 1 hour of headache onset. Conclusion.— Almotriptan 12.5 mg was efficacious in providing 2‐hour pain free, 2‐hour pain relief, SPF, and reducing rescue medication use irrespective of the presence of AAS at the time of treatment. The most optimal efficacy outcomes occurred when patients treated migraine attacks early and before the onset of severe pain. The presence of AAS, which may indicate an early phase of allodynia, did not influence the efficacy of almotriptan therapy.