A study conducted by researchers at Thomas Jefferson University, Philadelphia, and published Tuesday, July 27, 2004, in the journal Neurology, shows that Frova (frovatriptan), a triptan class migraine therapy with a long half life, significantly reduced the incidence of menstrual associated migraines (MAM) in women who took the medication preventively, in advance of anticipated onset of headache.
There is no therapy currently indicated for prevention of MAM headaches. Frova is currently indicated for short-term management of migraine.
In this study MAM was defined as a headache occurring regularly in close relationship to the onset of menstruation (between two days prior to and up to four days after the onset of bleeding). Some reports suggest that MAM headaches are more resistant to treatment, and may be more prone to recur compared to migraines that occur at other times during the month. Thirty-three percent of women who get regular migraines begin to experience them at the onset of their first menstrual cycle. It is likely that the reason women experience MAM is related to changes in female sex hormone levels that occur at menstruation.
“There is strong need for preventive intervention, or mini-prophylaxis, for those women who suffer regular, prolonged MAM attacks, and effectively lose several days each month because they are unable to function adequately either at work or at home,” said the lead author of the article, Stephen Silberstein, M.D., FACP, professor of Neurology, Jefferson Medical College of Thomas Jefferson University, and director, Jefferson Headache Center, Thomas Jefferson University Hospital. “Frovatriptan has a 26 hour half life, which is associated with a long duration of action and a low risk of headache recurrence. These characteristics suggest that it could be particularly useful in treating MAM attacks, which tend to be prolonged and are prone to recur.”
The double-blind, placebo-controlled study included more than 500 female patients who experience MAMs drawn from 36 centers in the United States. At the start of the study, patients identified the dates on which their MAM would most likely occur over the following three months. Participants were randomized to receive either placebo, Frova 2.5 mg once-daily or Frova 2.5 mg twice daily for six days. The patients were instructed to start taking their study medication two days before the anticipated MAM onset date for each of the treated menstrual periods.