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Printable Handouts
Navigable Slide Index
- Introduction
- Conflict of interest statement
- The origins of sumatriptan
- First into humans
- Conclusion (1)
- War of the triptans (1)
- The second triptan: alniditan
- War of the triptans (2)
- The migraine patient in Innsbruck
- Conclusion (2)
- The triptan bonanza
- Conclusion (3)
- Sumatriptan overuse
- Frequent use of serotonin agonists
- Medication Overuse Headache (MOH)
- Conclusion (4)
- Emergency room: intravenous aspirin
- My major failures
- Conclusion (5)
- Zolmitriptan in the treatment of migraine attacks
- The role of placebo in acute migraine trials
- Randomization 4:4:1
- Conclusion (6)
- 2x placebo
- Topiramate in migraine prophylaxis
- Conclusion (7)
- Cessation vs. continuation of 6-month prevention
- Conclusion (8)
- A new era in migraine treatment
- Conclusion (9)
- CGRP-antibodies for migraine prevention
- Health technology assessment
- Conclusion (10)
- Prevention of migraine: erenumab vs. topiramate
- Conclusion (11)
- Published IHS guidelines
- Adherence to IHS guidelines
- Pain free or pain response?
- Studies on acute therapy and prophylaxis of migraine
- 747 studies in the prophylaxis of migraine
- Conclusion (12)
- Why is everyone suddenly afraid of triptans?
- Assumed mode of action of sumatriptan
- Sumatriptan prescription information (FDA)
- Pathophysiology of acute coronary syndrome
- Meta-analysis: cardiovascular events
- Risk of myocardial infarction with sumatriptan
- Conclusion (13)
- CGRP and migraine
- Conclusion: CGRP-targeted drugs
- When monoclonal antibodies should not be used
- Final conclusions
- Pitfalls in headache trials
- Thank you
Topics Covered
- Sumatriptan
- Migraine prevention and treatment
- Clinical trial design
- Serotonin receptor agonists
- Therapeutic drug development
- Medication Overuse Headache (MOH)
- Zolmitriptan
- Placebo
- Topiramate
- CGRP receptor antagonists
Links
Series:
Categories:
Therapeutic Areas:
Talk Citation
Diener, H. (2023, October 31). Mistakes we make in headache trials [Video file]. In The Biomedical & Life Sciences Collection, Henry Stewart Talks. Retrieved October 16, 2024, from https://doi.org/10.69645/MFAK5812.Export Citation (RIS)
Publication History
Financial Disclosures
- Dr. Diener received honoraria for participation in clinical trials, contribution to advisory boards or oral presentations from: Lilly, Novartis, Pfizer, Teva, Weber & Weber and WebMD. The German Research Council (DFG), the German Ministry of Education and Research (BMBF) and the European Union support headache research by HCD. HCD serves on the editorial boards of Cephalalgia, Lancet Neurology and Drugs. HCD is a member of the Clinical Guidelines Committee of the German Society of Neurology and of the Clinical Trials Committee of the IHS.
Other Talks in the Series: Toward a Deeper Understanding of Headache and Migraine
Transcript
Please wait while the transcript is being prepared...
0:00
Ladies and gentlemen,
dear colleagues.
I'm Hans-Christoph
Diener, Chair of
the Department of
Neuroepidemiology
at the University
of Duisburg-Essen.
For over 30 years,
I ran a headache clinic.
The topic of my talk is
mistakes that we made in the
past in headache trials.
You may be surprised
at the choice.
There is a very
easy explanation.
Some years ago, I was invited to
deliver a talk at
an award ceremony.
There were two people who got
an award of which I was one.
We were asked to tell about
our major achievements
in headache research.
I thought if people hear from
the first speaker about
his achievements,
it's most probably better for me
as a second speaker to talk
about some mistakes that
my colleagues and I made
in the last 30 years.
In research, we learn
from our mistakes.
0:56
This is my conflict
of interest slide.
Most of my research
has been funded by
the German Research
Council and the
German Ministry of
Education and Research.
1:08
The whole story of
triptans started in
a very peculiar way.
A pharmaceutical company
had identified that
venous vessels contain
serotonin 5-HT,
and had asked a group of
pharmacologists to
develop a drug for
venous insufficiency
targeting 5-HT receptors.
But the drug did not work.
However, safety
experiments showed that it
constricted meningeal
arteries, and at that time,
the pathophysiology of
migraine was believed to
involve vessel dilation in
the brain and meninges
during a migraine attack.
Consequently, this
led to the hypothesis
that the drug might be used
to treat acute migraine attacks.