Early dosing and efficacy of triptans in acute migraine treatment: the TEMPO study

To compare the effectiveness of early or late triptan intake in the treatment of acute migraine attacks.

The TEMPO study was a French prospective, multicentre, two-phase study conducted in neurological practice. Two-hundred-and-ten migraine patients who were regular triptan users were enrolled. In the first phase, patients treated three attacks as they usually did. In the second phase, those who initially practiced late dosing ( ≥ 1 hour after headache onset) were instructed to change to early dosing ( < 1 hour).

A total of 144 patients completed the first phase. Seventy-nine patients constituted the 'early dosers' group and 65 patients the 'late dosers' group. In this phase, early dosing produced higher rates (n  =  38; 52.8%) of freedom from pain at 2 hours in at least two of three attacks compared with late dosing (n  =  19; 30.2%; p  <  0.01). In the second phase, switching from late to early dosing following the physician's instruction (n  =  42 patients) also improved the rates of freedom from pain at 2 hours (from 38.1% (n  =  16) to 53.7% (n  =  22); p  <  0.05).

This suggests that advising patients on the importance of early triptan intake after headache onset may help improve the efficacy of acute migraine treatments.