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Effectiveness of nasal sumatriptan in 5- to 12-year-old children
A D Hershey1, S W Powers, S LeCates
1Division of Neurology, Children's Hospital Medical Center, Cincinnati, Ohio 45229-3039, USA.
Insights
Nasal sumatriptan shows promise for treating migraines in children aged 5-12, with 82.5% of treated headaches responding. Further placebo-controlled studies are needed to confirm its effectiveness in this young population.
Area of Science:
- Pediatric Neurology
- Clinical Pharmacology
- Migraine Treatment
Background:
- Headaches are common in children, affecting up to 10.6%.
- Oral migraine medications are often ineffective for children with significant vomiting.
- Nasal sumatriptan has shown efficacy in adolescents but requires evaluation in younger children.
Purpose of the Study:
- To evaluate the tolerability and effectiveness of nasal sumatriptan for migraine in children aged 5 to 12 years.
- To explore potential subgroups of young migraineurs who may benefit from this treatment.
Main Methods:
- Ten children (aged 5-12) with migraine unresponsive to oral medication or with vomiting received nasal sumatriptan (5mg or 20mg).
- Initial administration and tolerability were assessed in a clinical setting.
- Effectiveness was evaluated through follow-up contact with patients or parents.
Main Results:
- 82.5% of treated headaches (47 out of 57) responded to nasal sumatriptan.
- 6 out of 10 patients experienced a 100% response, 2 had a 50% response, and 1 had no response.
- The most common side effect reported was a persistent bad taste (3 patients).
Conclusions:
- Nasal sumatriptan appears to be an effective option for aborting migraines in young children (5-12 years).
- Specific patient subgroups may respond particularly well to this treatment.
- Further double-blind, placebo-controlled trials are warranted to establish definitive efficacy in this age group.
Objective:
To assess the tolerability and effectiveness of nasal sumatriptan in the treatment of migraine in 5- to 12-year-old children.
Background:
Although headaches are a common disorder and occur in up to 10.6% of children, many of the new migraine abortive agents have not been well evaluated in this population. It has recently been reported that nasal sumatriptan is effective in the treatment of migraine in adolescents. In younger children, it is yet to be characterized. In addition, many children have significant amounts of vomiting with their migraines, limiting their use of oral medications.
Design And Methods:
Children with headache were evaluated by a child neurologist, child psychologist, and pediatric nurse practitioner. Clinical and International Headache Society diagnoses were established for each child. Patients with headaches that were either unresponsive to oral medications or had significant vomiting were treated with nasal sumatriptan. Initial administration and tolerability were performed in the Headache Center at Cincinnati's Children's Hospital Medical Center. Patients or their parents were contacted to assess the overall effectiveness of nasal sumatriptan after home administration.
Results:
Ten patients aged between 5 and 12 years (mean, 9.9 years) received either a 5-mg (n = 2) or 20-mg (n = 8) dose of sumatriptan. All 10 patients had a clinical diagnosis of migraine; 7 met the International Headache Society criteria for migraine. The mean age of headache onset was 6.6 years. A total of 57 headaches were treated; 47 (82.5%) responded to sumatriptan. Of the patients who treated headaches, the mean number of headaches treated was 5.2, while the mean number of responsive headaches was 4.3. One patient had no response, 2 patients had a 50% response, and 6 patients had 100% response to the nasal sumatriptan. Three patients reported persistent "bad taste."
Conclusions:
This report demonstrates that nasal sumatriptan may be effective in aborting migraine in young children (aged 5 to 12 years). It also suggests that there may be subgroups for which it works well. This information suggests that double-blind, placebo-controlled studies are necessary to determine the overall effectiveness of nasal sumatriptan in this age group.
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