The Migraine Intervention Score (MIS) - a tool to improve efficacy of triptans in acute migraine therapy: The ALADIN study

Hartmut Göbel (1) , Axel Heinze (2)

1 Kiel Headache and Pain Centre
2 Kiel Headache and Pain Centre

Background: The "Migraine Intervention Score" (MIS) is a new self-administered scale that can be used to quantify the severity of specific migraine symptoms. The objective of the present study was to determine if MIS could be used to improve the efficacy of frovatriptan 2.5 mg in the early treatment of migraine attacks for clinical practice. Methods: In this prospective, observational study patients suffering from migraines with or without aura were enrolled and permitted to choose the time of self-medication with frovatriptan 2.5 mg. At the time of intake of medication, patients evaluated the severity of individual migraine symptoms using MIS. The scores for each symptom were then totalled to provide an overall level of symptom severity. A total of 1620 patients completed the treatment of 3 migraine attacks with frovatriptan. 1518 patients could be analyzed with respect to the documented efficacy parameters of the third attack. Patients initiating treatment at low symptom severity levels were compared to those initiating treatment at high symptom severity levels. Results: Time to the achievement of the primary endpoint (headache response) was significantly lower in patients who initiated treatment at low versus high symptom severity levels (42.06 ± 32.33 vs. 49.25 ± 34.92 min; p=0.0023). Likewise, patients who initiated treatment at low symptom severity levels achieved complete headache relief more rapidly (79.37 ± 65.33 vs. 96.05 ± 100.85 min; p=0.0109) and required escape medication less frequently (3.88% vs. 13.73%; p<0.0001). Conclusions: The initiation of attack treatment with frovatriptan at low severity of migraine symptoms is more effective than starting therapy at higher symptom levels. Together with the low recurrence headache rate, the decreased necessity for escape medication and the low number of tablets needed, these data demonstrate that operationalized intervention with frovatriptan 2.5 mg is a valuable method for improving the treatment of migraine attacks.

Mots clés: Medicine

Hartmut Göbel, Axel Heinze. The Migraine Intervention Score (MIS) - a tool to improve efficacy of triptans in acute migraine therapy: The ALADIN study. International Journal of Clinical Practice, 2011, 65 (8), pp.879. ⟨10.1111/j.1742-1241.2011.02720.x⟩. ⟨hal-00660040⟩