Conflicts of Interest: Dr. Ashcroft has previously received research funding from GlaxoSmithKline. This study was supported by the University of Manchester (UK), and the views expressed in this article are those of the authors alone.
Meta-Analysis of the Efficacy and Safety of Zolmitriptan in the Acute Treatment of Migraine
Article first published online: 27 DEC 2007
© 2007 Map Pharmaceuticals
Headache: The Journal of Head and Face Pain
Volume 48, Issue 2, pages 236–247, February 2008
How to Cite
Chen, L.-C. and Ashcroft, D. M. (2008), Meta-Analysis of the Efficacy and Safety of Zolmitriptan in the Acute Treatment of Migraine. Headache: The Journal of Head and Face Pain, 48: 236–247. doi: 10.1111/j.1526-4610.2007.01007.x
- Issue published online: 27 DEC 2007
- Article first published online: 27 DEC 2007
- Accepted for publication August 16, 2007.
- systematic review;
Objective.— To assess the relative efficacy and safety of zolmitriptan in the treatment of acute migraine attacks.
Background.— Zolmitriptan is a second-generation triptan developed for the treatment of migraine. Numerous randomized controlled trials (RCTs) have been carried out to compare different dosages and formulations of zolmitriptan against other treatments for acute migraine.
Methods.— Random effects meta-analysis of 24 RCTs, including 15,408 patients suffering from acute migraine attacks. Subgroup analyses compared differences in response between different dosages and formulations of zolmitriptan, and other triptan comparators.
Results.— Zolmitriptan 2.5 mg tablet was found to be as effective as almotriptan 12.5 mg, eletriptan 40 mg, sumatriptan 50 mg and 100 mg and more effective than naratriptan 2.5 mg in terms of 2-hour pain-free rates. Likewise, zolmitriptan 5 mg tablet was as effective as sumatriptan 50 mg and 100 mg in 2-hour pain-free rates. Compared against zolmitriptan 2.5 mg tablet, eletriptan 80 mg was more effective in achieving headache relief, pain-free and sustained pain-free responses, and rizatriptan 10 mg was more effective in terms of sustained pain-free rates. Zolmitriptan 2.5 mg tablet was associated with a lower risk of adverse events than eletriptan 80 mg but higher risk than naratriptan 2.5 mg and rizatriptan 10 mg. Zolmitriptan 5 mg tablet was superior to zolmitriptan 2.5 mg tablet in achieving 1- and 2-hour pain-free response. There were no significant differences in 1- and 2-hour headache relief and adverse event rates between the different formulations of zolmitriptan 2.5 mg.
Conclusions.— Zolmitriptan 2.5 mg tablet is an effective treatment for acute attacks of migraine showing similar efficacy to almotriptan 12.5 mg, eletriptan 40 mg, and sumatriptan 50 mg, and being more effective than naratriptan 2.5 mg in terms of pain-free response at 2 hours post dose. Zolmitriptan 2.5 mg tablet was also as effective as rizatriptan 10 mg in terms of headache relief and pain-free response but less effective in terms of sustained pain-free response.