NIH Registration Numbers: NCT00329459 and NCT00329355, ClinicalTrials.gov
Changes in Salivary Prostaglandin Levels During Menstrual Migraine With Associated Dysmenorrhea
Version of Record online: 26 MAR 2010
© 2010 the Authors. Journal compilation © 2010 American Headache Society
Headache: The Journal of Head and Face Pain
Volume 50, Issue 5, pages 844–851, May 2010
How to Cite
Durham, P. L., Vause, C. V., Derosier, F., McDonald, S., Cady, R. and Martin, V. (2010), Changes in Salivary Prostaglandin Levels During Menstrual Migraine With Associated Dysmenorrhea. Headache: The Journal of Head and Face Pain, 50: 844–851. doi: 10.1111/j.1526-4610.2010.01657.x
Financial support: Supported by GlaxoSmithKline, Inc. (Substudies TRX105850/TRX105852) and sponsored by POZEN, Inc.
Conflict of Interest: Frederick Derosier, DO, and Susan McDonald, MA, are employed by GlaxoSmithKline. Paul Durham, PhD, Roger Cady, MD, and Vince Martin, MD, receive support from GlaxoSmithKline. Carrie Vause, MS, has no conflict of interest.
- Issue online: 23 APR 2010
- Version of Record online: 26 MAR 2010
- Accepted for publication January 24, 2010.
Objective.— To measure prostaglandin levels in the saliva of individuals during menstrual migraine associated with dysmenorrhea (MMaD) and in response to treatment with a single tablet combination of sumatriptan succinate and naproxen sodium.
Background.— Prostaglandins are thought to play a role in MMaD as elevated serum prostaglandin levels have been reported during attacks of menstrual migraine and are increased in the menstrual fluid of women with dysmenorrhea. While triptans are the primary line of migraine treatment, nonsteriodal anti-inflammatory drugs are the most commonly prescribed therapy for dysmenorrhea symptoms. Data from recent clinical studies have provided evidence that treatment with a single tablet combination of sumatriptan and naproxen sodium is an effective abortive therapy for attacks of MMaD.
Methods.— Women diagnosed with MMaD were treated with a sumatriptan succinate and naproxen sodium single tablet combination or placebo at time of migraine attack. Saliva samples were collected at time of attack as well as 2 and 4 hours after treatment. PGD2, PGE2, PGF2, PGI2, and TXA2 levels were determined by enzyme-linked immunosorbent assay.
Results.— Elevated levels of PGD2, PGF2, and TXA2 at 2 and 4 hours and PGE2 at 4 hours were found in saliva obtained from placebo subjects when compared with onset of attack levels. However, in subjects treated with a single tablet combination of sumatriptan and naproxen sodium, the levels of PGD2, PGF2, and PGE2 were not elevated at either time point while TXA2 levels were still elevated at 4 hours.
Conclusions.— Data from this pilot study provide evidence that saliva levels of several prostaglandins increase during attacks of MMaD and that treatment with a single tablet combination of sumatriptan and naproxen sodium prevents elevation of prostaglandin levels.