The 40‐mg dose of eletriptan: comparative efficacy and tolerability versus sumatriptan 100 mg

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Abstract
Meta‐analysis provides valuable information regarding relative efficacies of triptans, but head‐to‐head comparator studies remain the gold standard. Three similar head‐to‐head trials comparing eletriptan 40 mg (E40) with sumatriptan 100 mg (S100) provide a rare opportunity and sufficient power, for robust comparisons of efficacy. Data were combined from three double‐blind, placebo‐controlled, first‐dose, first‐attack acute migraine treatment studies comparing E40 (n = 1132), S100 (n = 1129), and placebo (n = 645). The primary outcome was headache response at 2 h. Secondary outcomes included headache response at 1 h, pain‐free and functional responses, and sustained headache and pain‐free responses. Odds ratios were calculated for summary estimates of probability of response. There were higher headache response rates with eletriptan versus sumatriptan at 2 h (67% vs. 57%; P < 0.0001) and 1 h (34% vs. 26%; P < 0.0001). Eletriptan also had higher 2 h pain‐free (35% vs. 25%; P < 0.0001) and functional responses (67% vs. 58%; P < 0.0001). Sustained headache (42%) and pain‐free (22%) response rates were higher for eletriptan versus sumatriptan (34%, P < 0.0001; 15%, P < 0.0001). The probability of response for eletriptan versus sumatriptan ranged from 36% higher (relief of nausea) to 64% higher (sustained pain‐free rate). Combined analysis demonstrates that E40 has superior efficacy versus S100 across all clinically relevant outcomes.