Review of dose–response curves for acute antimigraine drugs: triptans, 5-HT_1F agonists and CGRP antagonists

Abstract

Introduction: Dose–response curves for efficacy and tolerability are the important determinants for the choice of doses of acute migraine drugs.

Areas covered: Dose–response curves for the efficacy of seven triptans (5-HT_1B/1D receptor agonists), a 5-HT_1F receptor agonist (lasmiditan) and four oral calcitonin-gene related peptide receptor antagonists (telcagepant, MK-3207, BI 44370 TA and BMS-927711) in placebo-controlled trials were reviewed. In addition, dose–response curves for adverse events (AEs) were reviewed.

Expert opinion: For most triptans, the dose–response curve for efficacy is flat, whereas AEs often increase with increasing doses. The two other groups of drugs also have flat dose–response curves for efficacy. Overall, the triptans still have the most favorable efficacy-tolerability profile. Current acute antimigraine drugs do not fulfill the expectations of the patients, and thus, there are many unmet needs. Although upcoming drugs may not be superior to triptans, migraine patients will potentially benefit greatly from these, especially patients who are triptan non-responders and patients with cardiovascular disease.

Keywords:

• acute treatment
• adverse events
• dose–response curve
• efficacy
• migraine.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Notes

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