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Treatment with telmisartan, a long-acting angiotensin II receptor blocker, prevents migraine attacks in Japanese non-responders to lomerizine

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Abstract

Lomerizine, calcium channel blocker, is the most used medication for migraine prophylaxis in Japan. The effectiveness of this drug is reported as 50–75%. Telmisartan is angiotensin II receptor blockers which plasma half-life is 24 h. We examined whether telmisartan has preventative benefits in lomerizine non-responsive migraineurs. Lomerizine non-responders received telmisartan (20 mg/day) for 3 months after the investigation period of 3 months. Blood pressure, frequency of headache days/month, headache severity, and doses of triptans and analgesics were analyzed by Wilcoxon signed rank test. Thirty-three migraineurs (25 women and 8 men) participated in this study. Seven patients had migraine with aura and 26 patients had migraine without aura. Mean age (SD) was 46.6 (10.3) years. Mean duration (SD) of migraine was 20.4 (12.5) years. Headache severity exhibited mild degree in 5 patients, moderate degree in 9 patients and severe degree in 19 patients. Mean frequency (SD) of headache days was 10.9 (8.5) days/month. Mean usage (SD) of triptans was 4.8 (5.1) tablets/month and that of analgesics was 15.2 (22.2) tablets/month. Five patients (15%) had hypertension. Telmisartan administration had benefits in 30 patients (90%). This medication significantly decreased frequency of headache days (P < 0.01) and headache severity (P < 0.01). Doses of triptans were reduced at one-third (P < 0.05) and those of analgesia at one-fifth after telmisartan treatment (P < 0.01). After telmisartan, mean (SD) of systolic blood pressure was significantly decreased (P < 0.05). The present study supported that telmisartan treatment had preventive effects in 90% of lomerizine non-responders. Telmisartan non-responders (10%) exhibited chronic migraine and long migraine duration.

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Acknowledgements

We would like to thank the director and chief professor Masaki Tamura, PL Tokyo Health Care Center, Tokyo, Japan for the critical suggestion and support in this study.

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Authors and Affiliations

  1. Department of Neurology, Toho University Omori Medical Center, 6-11-1, Omorinishi, Otaku, Tokyo, 143-8541, Japan

    Ken Ikeda, Sayori Hanashiro, Yuichi Ishikawa, Masahiro Sawada, Maya Kyuzen, Harumi Morioka, Junya Ebina, Junpei Nagasawa, Masaru Yanagihashi, Ken Miura, Takehisa Hirayama, Takanori Takazawa, Osamu Kano, Kiyokazu Kawabe & Yasuo Iwasaki

  2. Department of Neurology, PL Tokyo Heath Care Center, Tokyo, Japan

    Ken Ikeda & Yasuo Iwasaki

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  1. Ken Ikeda
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Correspondence to Ken Ikeda.

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The authors declare that there is no financial support or relationship that may pose conflicts of interest and no potential conflicts of interest were disclosed.

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Ikeda, K., Hanashiro, S., Ishikawa, Y. et al. Treatment with telmisartan, a long-acting angiotensin II receptor blocker, prevents migraine attacks in Japanese non-responders to lomerizine. Neurol Sci 38, 827–831 (2017). https://doi.org/10.1007/s10072-017-2854-4

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