Safety trial with the 5HT1B/1D agonist avitriptan (BMS-180048) in patients with migraine who have experienced pressure, tightness, and/or pain in the chest, neck, and/or throat following sumatriptan

被引:15
作者
Dahlof, CGH
Falk, L
Risenfors, M
Lewis, CP
机构
[1] Sociala Huset, Gothenburg Migraine Clin, S-41117 Gothenburg, Sweden
[2] Cent Hosp Molndal, SU, Dept Cardiol, Molndal, Sweden
[3] Bristol Myers Squibb Pharmaceut Res Inst, Wallingford, CT USA
关键词
adverse events; avitriptan; chest symptoms; migraine; safety;
D O I
10.1046/j.1468-2982.1998.1808546.x
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
We investigate whether symptoms of pressure, tightness, and/or pain in the chest, neck, and/or throat after administration of the 5HT(1B/1D) agonist avitriptan were associated with objective impairment of the myocardial function on 12-lead electrocardiogram (ECC), continuous ECG (Wolter) monitoring, and echocardiography. Migraine sufferers who in two-thirds of all attacks treated with sumatriptan had experienced chest/throat/neck symptoms were chosen for study. Baseline measures included vital signs, a 12-lead ECG and an echocardiogram. Patients (n=51) who had no clinically significant abnormality at baseline received a high dose (150 mg) of avitriptan orally outside of a migraine attack. If pressure, tightness, and/or pain. in the chest, neck, and/or throat occurred, an ECG was obtained, and a repeat echocardiogram was done while the symptoms were present in order to monitor for impairment of myocardial function. If symptoms of these types did not occur within 60 min after administration of the study drug, a second echocardiogram was obtained. Forty-five patients (88%) reported at least one adverse event and 23 (45%) experienced pressure, tightness, and/or pain in the chest, neck, and/or throat after administration of avitriptan. No clinically significant myocardial abnormalities were observed in any patient, even in those who had experienced the targeted symptoms. No other serious adverse event occurred. We concluded that the typical 5HT(1B/1D) agonist-induced chest/throat/neck symptoms are most unlikely to be of cardiovascular origin.
引用
收藏
页码:546 / 551
页数:6
相关论文
共 57 条
[1]  
Abbrescia Vincent D., 1997, Journal of the American Osteopathic Association, V97, P162
[2]  
Abrahamsen B, 1992, Ugeskr Laeger, V154, P3602
[3]   5-HT RECEPTORS MEDIATING CONTRACTIONS OF THE ISOLATED HUMAN CORONARY-ARTERY [J].
BAX, WA ;
RENZENBRINK, GJ ;
VANHEUVENNOLSEN, D ;
THIJSSEN, EJM ;
BOS, E ;
SAXENA, PR .
EUROPEAN JOURNAL OF PHARMACOLOGY, 1993, 239 (1-3) :203-210
[4]  
BOYD IW, 1994, LANCET, V344, P1704
[5]  
CASTLE WM, 1992, BRIT MED J, V305, P117, DOI 10.1136/bmj.305.6845.117-c
[6]   Evaluation of hibernating myocardium in patients with ischemic heart disease [J].
Castro, PF ;
Bourge, RC ;
Foster, RE .
AMERICAN JOURNAL OF MEDICINE, 1998, 104 (01) :69-77
[7]   5-HYDROXYTRYPTAMINE CONTRACTS HUMAN CORONARY-ARTERIES PREDOMINANTLY VIA 5-HT2 RECEPTOR ACTIVATION [J].
CONNOR, HE ;
FENIUK, W ;
HUMPHREY, PPA .
EUROPEAN JOURNAL OF PHARMACOLOGY, 1989, 161 (01) :91-94
[8]   CLINICAL-EXPERIENCES FROM SWEDEN ON THE USE OF SUBCUTANEOUSLY ADMINISTERED SUMATRIPTAN IN MIGRAINE AND CLUSTER HEADACHE [J].
DAHLOF, C ;
EKBOM, K ;
PERSSON, L .
ARCHIVES OF NEUROLOGY, 1994, 51 (12) :1256-1261
[9]  
DAHLOF C, 1998, HEADACHE
[10]   Cardiovascular safety of 5HT1B/1D agonists -: Is there a cause for concern? [J].
Dahlof, CGH ;
Mathew, N .
CEPHALALGIA, 1998, 18 (08) :539-545