{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T19:32:48Z","timestamp":1777491168300,"version":"3.51.4"},"reference-count":45,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2020,9,9]],"date-time":"2020-09-09T00:00:00Z","timestamp":1599609600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Cephalalgia"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Migraine patients want acute treatment to provide complete relief of the migraine attack within 30 minutes. Traditionally, \u201cspeed of onset of effect\u201d is evaluated by estimating the time-point for first statistical separation of drug and placebo. The estimated onset of effect can be a few percent difference of patients being pain free in very large randomised, controlled trials. This difference, however, can be clinically irrelevant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Placebo-controlled randomised, controlled trials with pain freedom results from 30\u2009min to 2\u20134 hours were retrieved from the literature. For each time-point, the therapeutic gain (drug\u2009minus placebo) (TG) was calculated. Therapeutic gain for being pain free of 5% was chosen for the definition of \u201conset of action\u201d, since this is approximately 1\/3 of the 16% TG and 1\/4 of 21% of TG for sumatriptan 50\u2009mg and 100\u2009mg, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 22 time-effect curves based on randomised, controlled trials were analysed. Based on the \u201conset of action\u201d of 5% pain freedom, the evaluated drugs and administration forms can be classified as follows: i) Early time to onset, \u226430\u2009min (three randomised, controlled trials); ii) medium time to onset, 60\u2009min (nine randomised, controlled trials); iii) delayed time to onset, 90\u2013120\u2009min (10 randomised, controlled trials).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Only three non-oral administration forms with a triptan (subcutaneous sumatriptan and nasal zolmitriptan) resulted in an \u201conset of action\u201d at \u226530\u2009min; in the future, early onset of action should be a priority in the development of new drugs or new administration-forms for the treatment of acute migraine attacks.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0333102420956916","type":"journal-article","created":{"date-parts":[[2020,9,9]],"date-time":"2020-09-09T13:40:30Z","timestamp":1599658830000},"page":"148-155","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Onset of action in placebo-controlled migraine attacks trials: A literature review and recommendation"],"prefix":"10.1177","volume":"41","author":[{"given":"Peer","family":"Tfelt-Hansen","sequence":"first","affiliation":[{"name":"Danish Headache Center, Department of Neurology, Rigshospitalet-Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Glostrup, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hans-Christoph","family":"Diener","sequence":"additional","affiliation":[{"name":"Institute for Medical Informatics, Biometry and Epidemiology, Medical Faculty of the University Duisburg-Essen, Essen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2020,9,9]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1468-2982.2000.00117.x"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/0333102411417901"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/0333102419828967"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1468-2982.1998.1808532.x"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.2165\/00003495-200060060-00003"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1468-2982.2001.00169.x"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.2165\/00003495-200666080-00010"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1468-2982.2002.00404.x"},{"issue":"5","key":"e_1_3_2_10_2","first-page":"CD00910816","article-title":"Sumatriptan (all routes of administration) for acute migraine attacks in adults \u2013 overview of Cochrane reviews.","author":"Derry CD","year":"2014","unstructured":"Derry CD, Derry S, Moore RA. 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