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Changes in Salivary Prostaglandin Levels During Menstrual Migraine With Associated Dysmenorrhea

Authors

  • Paul L. Durham PhD,

    1. From the Center for Biomedical & Life Sciences, Missouri State University, Springfield, MO, USA (P.L. Durham and C.V. Vause); GlaxoSmithKline, RTP, NC, USA (F. Derosier and S. McDonald); Banyan Group, Inc., Springfield, MO, USA (R. Cady); Department of Internal Medicine, University of Cincinnati, Cincinnati, OH, USA (V. Martin).
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  • Carrie V. Vause MS,

    1. From the Center for Biomedical & Life Sciences, Missouri State University, Springfield, MO, USA (P.L. Durham and C.V. Vause); GlaxoSmithKline, RTP, NC, USA (F. Derosier and S. McDonald); Banyan Group, Inc., Springfield, MO, USA (R. Cady); Department of Internal Medicine, University of Cincinnati, Cincinnati, OH, USA (V. Martin).
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  • Frederick Derosier DO,

    1. From the Center for Biomedical & Life Sciences, Missouri State University, Springfield, MO, USA (P.L. Durham and C.V. Vause); GlaxoSmithKline, RTP, NC, USA (F. Derosier and S. McDonald); Banyan Group, Inc., Springfield, MO, USA (R. Cady); Department of Internal Medicine, University of Cincinnati, Cincinnati, OH, USA (V. Martin).
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  • Susan McDonald MA,

    1. From the Center for Biomedical & Life Sciences, Missouri State University, Springfield, MO, USA (P.L. Durham and C.V. Vause); GlaxoSmithKline, RTP, NC, USA (F. Derosier and S. McDonald); Banyan Group, Inc., Springfield, MO, USA (R. Cady); Department of Internal Medicine, University of Cincinnati, Cincinnati, OH, USA (V. Martin).
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  • Roger Cady MD,

    1. From the Center for Biomedical & Life Sciences, Missouri State University, Springfield, MO, USA (P.L. Durham and C.V. Vause); GlaxoSmithKline, RTP, NC, USA (F. Derosier and S. McDonald); Banyan Group, Inc., Springfield, MO, USA (R. Cady); Department of Internal Medicine, University of Cincinnati, Cincinnati, OH, USA (V. Martin).
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  • Vincent Martin MD

    1. From the Center for Biomedical & Life Sciences, Missouri State University, Springfield, MO, USA (P.L. Durham and C.V. Vause); GlaxoSmithKline, RTP, NC, USA (F. Derosier and S. McDonald); Banyan Group, Inc., Springfield, MO, USA (R. Cady); Department of Internal Medicine, University of Cincinnati, Cincinnati, OH, USA (V. Martin).
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  • NIH Registration Numbers: NCT00329459 and NCT00329355, ClinicalTrials.gov

  • 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.

P.L. Durham, Center for Biomedical & Life Sciences, Missouri State University, Springfield, MO 65806, USA.

Abstract

(Headache 2010;50:844-851)

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.

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