Correlation Between Lipophilicity and Triptan Outcomes

Authors

  • Julio Pascual MD,

  • Pedro Muñoz MD


  • From the University Hospital M de Valdecilla, Santander, Spain (Dr. Pascual); and Primary Care Management, Santander, Spain (Dr. Muñoz).

Address all correspondence to Dr. Julio Pascual, University Hospital Marqués de Valdecilla, 39008 Santander, Spain.

Abstract

Background.—It has been suggested that triptans achieving higher central nervous system (CNS) levels should have an advantage in efficacy, if central actions are important.

Objective.—Our aim was to correlate the efficacy and tolerability results of triptans with their lipophilicity.

Methods.—Data for response and pain free at 2 hours, recurrence, adverse events (AE), CNS AE, and chest symptoms taken from Ferrari et al's meta-analysis publications for the recommended doses of oral triptans were correlated with their lipophilicity coefficients (logDpH7.4 =−2.1 almotriptan < −1.5 sumatriptan < −1.0 zolmitriptan < −0.7 rizatriptan < −0.2 naratriptan < 0.5 eletriptan).

Results.—We found no significant correlation between lipophilicity coefficients and any of the analyzed parameters. There was, however, some correlation between lipophilicity and CNS AE (P= .09, r= 0.74) and, to a lesser degree, with a reduction in recurrence rate (r=−0.36). The r values for response and pain free with placebo correction ranged from 0.04 to 0.34, suggesting almost no correlation between lipophilicity and efficacy variables.

Conclusions.—According to this analysis, a higher lipophilicity does not seem crucial to improve triptan efficacy. This physico-chemical property, however, correlates with higher CNS AE and, possibly, lower recurrence rates.

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