Randomized, controlled study of telcagepant in patients with migraine and coronary artery disease.

Journal Article (Clinical Trial;Journal Article;Multicenter Study)

OBJECTIVE: To evaluate the efficacy of telcagepant in patients with migraine and coronary artery disease. BACKGROUND: Calcitonin gene-related peptide receptor antagonists, such as telcagepant, may be useful for acute migraine treatment in patients with cardiovascular disease, a population for whom triptans are contraindicated. METHODS: Randomized, double-blind, two-period (6 weeks per period) crossover study in patients with stable coronary artery disease and migraine. Patients were randomized 1:1 to either: (1) Period 1: telcagepant (280-mg tablet/300-mg capsule), Period 2: acetaminophen (1000-mg); or (2) Period 1: placebo for attack 1 then acetaminophen for subsequent attacks, Period 2: telcagepant. Patients could treat up to 12 migraine attacks per period to assess the tolerability of telcagepant. The primary efficacy analysis evaluated telcagepant vs placebo on 2-hour pain freedom during the first attack of Period 1. RESULTS: One hundred and sixty-five of the planned 400 patients were enrolled, and 114 took at least one dose of treatment. Telcagepant was not statistically different from placebo for 2-hour pain freedom (25.0% vs 18.9%, odds ratio = 1.62 [95% confidence interval: 0.62, 4.25]). The median number of attacks treated per period was 3. No cardiovascular thrombotic adverse events occurred within 14 days of dosing. CONCLUSION: The study was underpowered due to enrollment difficulties and did not demonstrate a significant efficacy difference between telcagepant and placebo for the treatment of a migraine attack in patients with stable coronary artery disease. Telcagepant was generally well tolerated for acute intermittent migraine treatment in these patients.

Full Text

Duke Authors

Cited Authors

  • Ho, TW; Ho, AP; Chaitman, BR; Johnson, C; Mathew, NT; Kost, J; Fan, X; Aurora, SK; Brandes, JL; Fei, K; Beebe, L; Lines, C; Krucoff, MW

Published Date

  • February 2012

Published In

Volume / Issue

  • 52 / 2

Start / End Page

  • 224 - 235

PubMed ID

  • 22221076

Electronic International Standard Serial Number (EISSN)

  • 1526-4610

Digital Object Identifier (DOI)

  • 10.1111/j.1526-4610.2011.02052.x


  • eng

Conference Location

  • United States