Sumatriptan

Sumatriptan succinate is a selective 5-HT1 receptor agonist with specificity towards 5-HT1D, 5-HT1B and 5-HT1A. In addition, the physicochemical properties of Sumatriptan succinate can be characterized using FT-IR, HPLC, SEM and XRD.

A multicenter, open-label, long-term safety and tolerability study of DFN-02, an intranasal spray of sumatriptan 10 mg plus permeation enhancer DDM, for the acute treatment of episodic migraine.[Pubmed:28251391]

J Headache Pain. 2017 Dec;18(1):31.

BACKGROUND: DFN-02 is a novel intranasal spray formulation composed of Sumatriptan 10 mg and a permeation-enhancing excipient comprised of 0.2% 1-O-n-Dodecyl-beta-D-Maltopyranoside (DDM). This composition of DFN-02 allows Sumatriptan to be rapidly absorbed into the systemic circulation and exhibit pharmacokinetics comparable to subcutaneously administered Sumatriptan. Rapid rate of absorption is suggested to be important for optimal efficacy. The objective of this study was to evaluate the safety and tolerability of DFN-02 (10 mg) in the acute treatment of episodic migraine with and without aura over a 6-month period based on the incidence of treatment-emergent adverse events and the evaluation of results of clinical laboratory tests, vital signs, physical examination, and electrocardiograms. METHODS: This was a multi-center, open-label, repeat-dose safety study in adults with episodic migraine with and without aura. Subjects diagnosed with migraine with or without aura according to the criteria set forth in the International Classification of Headache Disorders, 2nd edition, who experienced 2 to 6 attacks per month with fewer than 15 headache days per month and at least 48 headache-free hours between attacks, used DFN-02 to treat their migraine attacks acutely over the course of 6 months. RESULTS: A total of 173 subjects was enrolled, 167 (96.5%) subjects used at least 1 dose of study medication and were evaluable for safety, and 134 (77.5%) subjects completed the 6-month study. A total of 2211 migraine attacks was reported, and 3292 doses of DFN-02 were administered; mean per subject monthly use of DFN-02 was 3.6 doses. Adverse events were those expected for triptans, as well as for nasally administered compounds. No new safety signals emerged. Dysgeusia and application site pain were the most commonly reported treatment-emergent adverse events over 6 months (21% and 30.5%, respectively). Most of the treatment-emergent adverse events were mild. There were 5 serious adverse events, all considered unrelated to the study medication; the early discontinuation rate was 22.5% over the 6-month treatment period. CONCLUSION: DFN-02 was shown to be well tolerated when used over 6 months to treat episodic migraine acutely.

Subcutaneous sumatriptan delivery devices: comparative ease of use and preference among migraineurs.[Pubmed:28176899]

Patient Prefer Adherence. 2017 Jan 19;11:121-129.

BACKGROUND: Several Sumatriptan subcutaneous autoinjector devices for acute treatment of migraine patients are available, each device differs with respect to design and features. Determining device preference and ease of use is important because patients experiencing a migraine attack are often functionally impaired. OBJECTIVE: The objective of this human factors study was to compare migraine patients' device use performance and preferences for three Sumatriptan subcutaneous autoinjectors: a disposable two-step device (Zembrace((R)) SymTouch((R))), a disposable three-step device (Sumavel((R)) DosePro((R))), and a multistep reloadable device (Imitrex((R)) STATdose((R))), using simulated injections. METHODS: Each study subject performed two unaided simulated injections with each of three different drug delivery devices, which were presented in counterbalanced order. The participants were then asked to rate the three devices on various subjective measures. The primary end point was overall device preference using a visual analog scale. RESULTS: A total of 54 subjects participated and each subject performed two simulated injections with each of the three devices. Most subjects preferred the two-step device (88.9%) to the three-step (13.0%) and the reloadable (1.9%). The two-step device had higher mean overall preference ratings (F (2, 159)=56.6, P<0.01) and higher ratings for ease of use, intuitiveness, convenience, portability, and control. The two-step device had a first injection full-dose delivery success rate of 44.4%, higher than both the reloadable (24.1%) and the three-step (3.7%) devices. The number of errors with the two-step device (n=3) was ~90% lower than the three-step (n=49) and reloadable (n=44) devices. CONCLUSION: In this human factors study, 54 migraineurs used simulated injections to compare three Sumatriptan subcutaneous delivery devices. Zembrace SymTouch, a two-step device, was most preferred compared with Sumavel DosePro and Imitrex STATdose. It also ranked highest for ease of use and various other measures. In this study, migraine patients preferred the autoinjector that they rated as simpler and more intuitive.

Randomized, double-blind, crossover study comparing DFN-11 injection (3 mg subcutaneous sumatriptan) with 6 mg subcutaneous sumatriptan for the treatment of rapidly-escalating attacks of episodic migraine.[Pubmed:28176235]

J Headache Pain. 2017 Dec;18(1):17.

BACKGROUND: A 6-mg dose of SC Sumatriptan is the most efficacious and fast-acting acute treatment for migraine, but a 3-mg dose of SC Sumatriptan may improve tolerability while maintaining efficacy. METHODS: This randomized, double-blind, crossover study compared the efficacy and tolerability of 3 mg subcutaneous (SC) Sumatriptan (DFN-11) with 6 mg SC Sumatriptan in 20 adults with rapidly-escalating migraine attacks. Eligible subjects were randomized (1:1) to treat 1 attack with DFN-11 and matching placebo autoinjector consecutively or 2 DFN-11 autoinjectors consecutively and a second attack similarly but with the alternative dose (3 mg or 6 mg). RESULTS: The proportions of subjects who were pain-free at 60 min postdose, the primary endpoint, were similar following treatment with 3 mg SC Sumatriptan and 6 mg SC Sumatriptan (50% vs 52.6%, P = .87). The proportions of subjects experiencing pain relief (P >/= .48); reductions in migraine pain intensity (P >/= .78); and relief from nausea, photophobia, or phonophobia (P >/= .88) with 3 mg SC Sumatriptan and 6 mg SC Sumatriptan were similar, as were the mean scores for satisfaction with treatment (M = 2.6 vs M = 2.4, P = .81) and the mean number of rescue medications used (M = .11 vs M = .26, P = .32). The most common adverse events with the 3- and 6-mg doses were triptan sensations - paresthesia, neck pain, flushing, and involuntary muscle contractions of the neck - and the incidence of adverse events with both doses was similar (32 events total: 3 mg, n = 14 [44%]; 6 mg, n = 18 [56%], P = .60). Triptan sensations affected 4 subjects with the 6-mg dose only, 1 subject with the 3-mg dose only, and 7 subjects with both Sumatriptan doses. Chest pain affected 2 subjects (10%) treated with the 6-mg dose and no subjects (0%) treated with the 3-mg dose of DFN-11. There were no serious adverse events. CONCLUSIONS: The 3-mg SC dose of Sumatriptan in DFN-11 provided relief of migraine pain and associated symptoms comparable to a 6-mg SC dose of Sumatriptan. Tolerability was similar with both study medications; DFN-11 treatment was associated with fewer triptan sensations than the 6-mg dose. DFN-11, with its 3-mg dose of Sumatriptan, may be a clinically useful alternative to higher-dose autoinjectors.