Lipton 2009 Study 1.
Study characteristics | ||
Methods | Multicentre, R, DB, PC, cross‐over. Single dose per attack. 4 attacks treated: all with active or 3 active and 1 placebo (in random order). Washout between attacks not specified, but all headache medications prohibited within 24 h of a treated attack, and AE data collected for 72 h after treatment Medication taken within 1 h of onset when PI was mild Assessments at 0, 2, 4, 24 h |
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Participants | Migraine ± aura (IHS 2004), aged 18 to 65 years. History ≥ 6 months with frequency of 2 to 6 attacks per month and untreated severity ≥ moderate and identifiable mild phase Excluded: uncontrolled hypertension, cardio‐ or cerebrovascular disease N = 570 (568 for efficacy) F = 89% Mean age 42 years |
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Interventions | Sumatriptan plus naproxen 85/500 mg (1693 attacks treated) Placebo (424 attacks treated) 5 treatment groups with different medication sequences (Nap: naproxen; P: placebo; Sum: sumatriptan) P, Sum/Nap, Sum/Nap, Sum/Nap; Sum/Nap, P, Sum/Nap, Sum/Nap; Sum/Nap, Sum/Nap, P, Sum/Nap; Sum/Nap, Sum/Nap, Sum/Nap, P; Sum/Nap, Sum/Nap, Sum/Nap, Sum/Nap Rescue medication allowed after 2 h if necessary (recommended 2 x 220 mg naproxen sodium with additional 1 x 220 mg 6 h later if needed) |
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Outcomes | Pain‐free at 2 h 24‐h sustained pain‐free Presence and relief of associated symptoms at 2 h Use of rescue medication AEs Withdrawals |
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Notes | Oxford Quality Score: R1, DB1, W1. Total = 3 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | Not described |
Allocation concealment (selection bias) | Unclear risk | Not described |
Blinding (performance bias and detection bias) All outcomes | Unclear risk | Not described |
Incomplete outcome data (attrition bias) All outcomes | Low risk | Drop‐outs described |
Study size | Unclear risk | 50 to 200 participants per treatment arm |