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Timolol eyedrops promising treatment for acute migraine: JAMA
Kerala, India: Timolol eye drops can be considered for the acute treatment of migraine, suggests a recent study in the journal JAMA Ophthalmology. According to the study, treatment with the eye drops reduced the main score within 20 minutes suggesting that topical β-blockers may be a promising therapeutic option for the treatment of acute migraine attacks.
However, the researchers stated that further research is warranted to determine if the observed improvements are sustained for a longer period of time and with larger groups.
Oral β-blockers that have been used for the prevention of migraine headaches are not effective for acute pain treatment. Small case series have suggested topically applied β-blockers to be beneficial for the management of acute migraine pain. Henceforth, Abraham Kurian, Chaithanya Eye Hospital and Research Institute, Kesavadasapuram, Trivandrum, Kerala, India, and colleagues evaluated the short-term safety and efficacy of topically applied timolol maleate ophthalmic solution, 0.5%, compared with topically applied placebo eyedrops in the treatment of acute migraine attacks.
The study included 50 migraine patient (average age 27.3 years; 84% were female) who were randomized to receive either timolol maleate ophthalmic solution, 0.5%, or placebo eyedrops (carboxymethyl cellulose, 0.5%) and were instructed to use 1 drop of the medication in each eye at the onset of their migraine.
The primary outcome of the study was pain score reduction by 4 points, or to zero, 20 minutes following the installation of the eyedrop.
Key findings of the study include:
- Of a total of 619 migraine attacks, 46% were treated with timolol, 44% were treated with the placebo, and 10% occurred during the washout period when no study medications were used.
- Seven patients (14%) withdrew after randomization.
- A total of 233 of the timolol-treated migraine attacks (82%) were associated with a reduction in pain score by 4 points, or to zero, at 20 minutes compared with 38 of the placebo-treated attacks (14%), with a difference of 68 percentage points.
- A generalized estimating equation analysis revealed that pain score reduction at 20 minutes was greater in the timolol group compared with the placebo group by a mean (SE) of 4.63 points.
"These findings support consideration of timolol eye drops in the management of acute migraine attacks, but a confirmation for longer follow-up with larger groups at multiple sites is warranted," concluded the authors.
"Short-term Efficacy and Safety of Topical β-Blockers (Timolol Maleate Ophthalmic Solution, 0.5%) in Acute Migraine: A Randomized Crossover Trial," is published in the journal JAMA Ophthalmology.
DOI: https://jamanetwork.com/journals/jamaophthalmology/article-abstract/2771168
MSc. Biotechnology
Medha Baranwal joined Medical Dialogues as an Editor in 2018 for Speciality Medical Dialogues. She covers several medical specialties including Cardiac Sciences, Dentistry, Diabetes and Endo, Diagnostics, ENT, Gastroenterology, Neurosciences, and Radiology. She has completed her Bachelors in Biomedical Sciences from DU and then pursued Masters in Biotechnology from Amity University. She has a working experience of 5 years in the field of medical research writing, scientific writing, content writing, and content management. She can be contacted at editorial@medicaldialogues.in. Contact no. 011-43720751
Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751