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Dawn A. Marcus, MD

Arch Neurol. 2001;58:1056-1058.

The current International Headache Society guidelines for migraine clinical trials recommend assessment of pain relief at 2 hours as a primary end point. Patients, however, express a clear preference for more rapid pain relief, with most patients defining rapid relief as occurring within 30 minutes after drug administration. Thus, consideration should be given to establishing clinical trial end points that more accurately reflect the preferences of patients with migraine. In this case, assessment of pain relief at 1 hour would be an appropriate primary end point. Using speed of relief as a criterion for migraine drug selection also is appropriate. The migraine-specific serotonin_1B/1D agonists, or triptans, are able to meet this faster relief end point and are preferred by patients.

From the Departments of Anesthesiology and Neurology and Multidisciplinary Headache Clinic, University of Pittsburgh Medical Center, Pittsburgh, Pa.

Corresponding author: Dawn A. Marcus, MD, Pain Evaluation and Treatment Institute, 4601 Baum Blvd, Pittsburgh, PA 15213 (e-mail: dawnpainmd{at}yahoo.com).

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