Telcagepant to treat migraine
What is Telcagepant?
This is the novel CGRP inhibitor developed by Merck to treat acute migraine episodes. It used to be known as MK0974.
The latest on Telcagepant (MK0974) from American Headache Society Meeting in Boston
Dr Ho has presented his data, and reported on 1380 people with migraine.
These people were divided into four groups:
- Placebo
- Zolmitriptan 5mg
- Telcagepant 150mg
- Telcagepant 300mg
What happened to each group?
The main outcome was the percentage of people with pain relief at 2 hours, the data were as follows:
- Placebo 27% pain relief at 2 hours
- Zolmitriptan 5mg 56% pain relief at 2 hours
- Telcagepant 150mg 49% pain relief at 2 hours
- Telcagepant 300mg 55% pain relief at 2 hours
Side effects did not appear to be serious, but he made no mention of cardiac symptoms, which a re potential problem with the triptan drugs (like zolmitriptan).
In general Telcagepant was well tolerated, but dizziness, fatigue and vomiting were reported in a minority of patients (<6%).
What is the likely role for Telcagepant to treat migraine?
Most likely it will compete with the triptans for people whose migraine does not respond to anti-inflammatories or anti-emetics. There is s poster presentation later on the cardiac symptoms associated with telcagepant, and I will update once I’ve cast my critical eye on it.