Inpharma 1370 - 18 Jan 2003

Candesartan cilexetil: promisingprophylactic for migraine

The angiotensin II receptor antagonist, candesartancilexetil, may be an effective prophylactic agent forpatients with migraine, according to researchers fromNorway.

In their crossover study, 60 patients aged 18–65 yearswho experienced 2–6 migraine attacks per month weretreated with candesartan cilexetil 16mg and placebo,once daily for 12 months each, separated by a 4-weekplacebo washout period.*

In the intention-to-treat analysis (n = 57), comparedwith placebo, treatment with candesartan cilexetil wasassociated with significant reductions in the number ofheadache days, headache hours, migraine days,migraine hours, triptan doses, analgesic doses and sickleave days, and in the severity of headache and the levelof disability [see table].

Mean BP was significantly lowered during treatmentwith candesartan cilexetil, relative to placebo (115/70 vs126/77mm Hg). However, there was no significantbetween-group difference in adverse events.

Efficacy outcomes in patients with migraineaccording to therapyEfficacy Candesartan Placebo P valuemeasure cilexetil

Headache 13.6 18.5 0.001days

Headache 95 139 < 0.001hours

Migraine days 9 12.6 < 0.001Migraine 59.4 92.2 < 0.001hours

Disability 14.1 20.6 < 0.001level

Headache 191 293 < 0.001severityindex*

Triptan doses 6.9 9.5 0.03Analgesic 12.7 18.9 0.02doses

Sick leave 1.4 3.9 0.01days

* sum of the number of headache hours times the maximum headacheseverity (grade 1–4) for all headache days

* The study received financial support from AstraZeneca.

Tronvik E, et al. Prophylactic treatment of migraine with an angiotensin II receptorblocker: a randomized controlled trial. JAMA: the Journal of the AmericanMedical Association 289: 65-69, 1 Jan 2003 800925157

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Inpharma 18 Jan 2003 No. 13701173-8324/10/1370-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved