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Arthritis Drug May Help Migraines

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WebMD Health News

June 29, 2001 -- Migraine sufferers: More options for relief are in sight. An arthritis drug is showing great promise in treating and reducing the frequency of migraine attacks -- and with few side effects.

Three studies looking at the relatively new drug Vioxx -- an anti-inflammatory used to treat arthritis pain -- have found it to be very effective in treating migraines. Two of the studies analyze the effectiveness of Vioxx in combination with other drugs; one study looks at Vioxx by itself.

"[Vioxx] certainly looks like an improvement over previous arthritis medications prescribed for migraines," says Panayiotis Mitsias, MD, assistant professor of neurology at Case Western Reserve University in Cleveland and director of the headache clinic at Henry Ford Hospital and Health Sciences Center in Detroit.

One study looked at a combination treatment -- Vioxx and rizatriptan (also available as Maxalt). Rizatriptan is one of a new class of drugs called triptans that are prescribed for migraines. Vioxx seemed to boost the effects of rizatriptan, says study author Abouch Krymchantowski, MD, founder of the Headache Center of Rio in Rio de Janeiro, Brazil.

Used alone, rizatriptan "is one of the best of the triptans," he says, but "even though this medication is very good [and] very fast, compared to old options, only 70% [of patients] get relief in two hours, and 30% still have pain. Among those who get pain relief, they are still experiencing mild pain. They are not really pain free."

However, in Krymchantowski's study the Vioxx/rizatriptan combination resulted in high percentages of patients who were pain free in one hour, felt no nausea, and -- even more significantly -- had far fewer recurrences of migraines in the next 24 hours than did a group of patients given rizatriptan alone.

Though anti-inflammatory drugs have been used to treat migraine attacks, "the rate of success has been very limited," says Krychantowski. And because many migraine patients self-medicate with over-the-counter analgesics, they have considerable stomach problems.

However, Vioxx is easier on the stomach than other anti-inflammatory medications, and the combination with rizatriptan did not increase side effects, Krychantowski tells WebMD.

A second study found that migraine sufferers who took a combination of Vioxx and Singulair, an asthma drug that reduces inflammation, had a 35% reduction in frequency of migraine attacks, according to Fred Freitag, DO, associate director of the Diamond Headache Clinic in Chicago. After taking the drug combination for 12 weeks, 31 migraine patients experienced an average of 2.3 attacks per month, compared with 6.4 attacks before the study was started.

A third study from the University of South Florida College of Medicine suggests that Vioxx alone may help prevent migraine. Nearly two-thirds of patients who had regular migraines experienced a 50% or greater decrease in headaches.

"If [Vioxx] extends the effect of triptan treatment -- and prevents early headache recurrence -- that is most exciting," Mitsias tells WebMD. "Recurrence has a pretty high frequency with most of the triptans. It would also be interesting to see if this medication works with other types of headaches, not just migraines."

Krymchantowski's study was not sponsored by the pharmaceutical industry, but a small portion of Freitag's study was funded by Merck. Funding information was not available for the University of South Florida study.

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