Meta-analytic review of the effect of subcutaneous sumatriptan in migraine headache

Objective: To assess the size and consistency of the effects of sumatriptan 6 mg sc, compared with placebo, in the abortive treatment of migraine headaches across multiple studies using varied research designs and migraine diagnoses. Data Sources: English-language journal articles retrieved by a MEDLINE search of the years 1990-1994, International Pharmaceutical Abstracts, drug information personnel at Glaxo, Inc., and cited references of identified studies, as well as published reviews of sumatriptan; the search term was sumatriptan. Study Selection: All studies reporting results with sumatriptan 6 mg sc, compared with placebo, for the abortive treatment of migraine headaches were reviewed. The studies that were included varied with respect to research design used and migraine diagnosis. Data Extraction: Outcome measures included in this research were improvement at 60 and 120 minutes after administration, pain free at 60 and 120 minutes after administration, the need for a second dose, the need for rescue medication, and adverse effects. Individual study effect sizes were calculated for each outcome variable. Individual effect sizes were combined across all studies to determine the combined average effect size for each outcome measure. The effect size calculated for each outcome measure was both clinically and statistically significant. No statistically significant variations in the effects of sumatriptan, compared with placebo, on all outcome variables considered were detected. Conclusions: The effects of sumatriptan across studies are consistently large, clinically and statistically significant, and are independent of the research methods used (i.e., efficacy vs. effectiveness) and migraine diagnosis.