***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: An open , prospect i ve study was undertaken to assess the efficacy and safety of subcutaneous sumatriptan in 17 children , ages 6 to 16 years , with severe , recurrent migraine . A 6-mg dose was used in 15 patients and relieved headache within 1 hour in six and by 2 hours in five others . Two smaller children received a 3-mg dose and both were headache-free within 2 hours . Most also reported marked improvement in associated symptoms such as nausea and photophobia . Four subjects had no clinical improvement after a 6-mg dose . Side effects , such as neck pressure , were brief and mild . These findings suggest that subcutaneous sumatriptan can be both effective and safe as an abortive agent in juvenile migraine , but the appropriate dose in smaller children will need further investigation Objective . To compare the efficacy and tolerability of sumatriptan nasal spray ( NS ; 5 mg , 10 mg , and 20 mg ) with placebo for the treatment of acute migraine in adolescents . Methods . A r and omized , double-blind , placebo-controlled , single-attack study was conducted in 653 US adolescents ( 12–17 years of age ) . Patients with at least a 6-month history of migraine , who met International Headache Society criteria for migraine ( with or without aura ) were eligible for participation . Headache relief 2 hours postdose , complete relief , presence or absence of associated symptoms , headache recurrence , and use of rescue medications were recorded . The primary efficacy endpoint was headache relief 2 hours postdose sumatriptan NS ( 20 mg ) versus placebo .  Safety and tolerability were assessed by examining adverse events , changes in electrocardiograms , vital signs , physical examinations , and clinical laboratory tests . Results . Headache relief 1 hour postdose was significantly greater for patients using 10 mg ( 56 % ) and 20 mg ( 56 % ) of sumatriptan NS compared with placebo ( 41 % ) . Headache relief 2 hours postdose was significantly greater for patients using 5 mg of sumatriptan NS ( 66 % ) compared with placebo ( 53 % ) , and approached statistical significance for 20 mg ( 63 % ) compared with placebo ( 53 % ) . Complete relief 2 hours postdose was significantly greater for patients using 20 mg of sumatriptan NS compared with placebo ( 36 % vs 25 % , respectively ) . Each dose of sumatriptan ( 5 mg , 10 mg , and 20 mg ) was superior to placebo with respect to the cumulative percentages of patients first reporting headache relief within 2 hours of dosing ( Kaplan-Meier ) . The sumatriptan 20-mg dose was superior to placebo with respect to the cumulative percentages of patients first reporting complete relief within 2 hours of dosing ( Kaplan-Meier ) . Photophobia and phonophobia were significantly reduced 2 hours postdose for sumatriptan NS ( 20 mg ) , compared with placebo ( 36 % vs 48 % and 25 % vs 44 % , respectively ) . Taste disturbance was the most commonly reported adverse event ( 2 % , 19 % , 30 % , and 26 % for placebo , 5 mg , 10 mg , and 20 mg , respectively ) . No drug-related serious adverse events or clinical ly relevant changes in laboratory parameters , electrocardiograms , or vital signs were reported . Conclusions . Sumatriptan NS is effective and well-tolerated for the treatment of  acute migraine in adolescents , with the 20-mg dose providing the best overall efficacy and tolerability profiles BACKGROUND Eletriptan is a potent 5-HT(1B/1D ) agonist with proven efficacy in the acute treatment of migraine in adults . OBJECTIVE To evaluate the efficacy and tolerability of eletriptan 40 mg versus placebo in adolescent patients ( aged 12 - 17 ) . METHODS A multicenter , double-blind , parallel-group , placebo-controlled trial was conducted comparing 40 mg of oral eletriptan with placebo for the treatment of migraine in adolescent patients . The primary efficacy endpoint was 2-hour headache response , and a number of secondary endpoints were also evaluated . An exploratory analysis evaluated which clinical and demographic characteristics might be correlated with high placebo response . RESULTS Of 274 patients who treated a migraine attack , 267 were evaluated for efficacy ( n = 138 eletriptan ; n = 129 placebo ) at 2 hours post-dose . There was no significant difference in 2-hour headache response for eletriptan 40 mg versus placebo ( 57 % vs 57 % ) , and no significant improvements were observed for any of the outcomes at 1 or 2 hours post-dose . By contrast , there was a significant advantage for eletriptan 40 mg in reducing headache recurrence within 24 hours post-dose ( 11 % vs 25 % , P= .028 ) , and post hoc analyses showed statistically significant differences for sustained headache response rates ( 52 % vs 39 % ; P= .04 ) and sustained pain-free response rates ( 22 % vs 10 % ; P= .013 ) . The strongest clinical predictor of placebo response was triptan-naïve status ( i.e. , no previous use of any triptan ) . Eletriptan 40 mg was well tolerated in this population , and the profile of adverse events was similar to that observed in Phase III trials in adult patients . CONCLUSIONS The high placebo response rates reported here for 1- and 2-hour outcomes are in accordance with other studies of triptans in adolescent patients . The evaluation of treatment effect in adolescent migraine might benefit from use of more stringent outcome measures , such as headache recurrence , sustained headache response , and sustained pain-free response at 24 hours post-dose Frovatriptan is a selective 5-HT(1B/1D ) receptor agonist available for acute treatment of migraine in adults ( 18 years and older ) . The objective of this study was to determine key pharmacokinetic parameters of frovatriptan in adolescent migraineurs after a single 2.5-mg oral dose and to compare these results with those from an earlier study completed in adults . Subjects were stratified by age ( 12 - 14 and 15 - 17 years ) and gender , and serial blood and urine sample s were collected over 48 hours . A total of 25 subjects ( 13 male , 12 female ) completed the study .  Pharmacokinetic profiles for adolescent subjects were similar to those observed in adults . The median tmax ranged from 2 ( male subjects ) to 3 ( female subjects ) hours . The AUC0 - 24h and Cmax were slightly lower in adolescent subjects as compared with adults . As seen in adults , AUC0 - 24h and Cmax values were approximately 2-fold higher in females than in their male counterparts ( AUC mean range 40.5 - 59.8 ng x h/mL vs 21.2 - 23.5 ng x h/mL and Cmax mean range 4.02 - 6.14 vs ng x h/mL 2.52 - 2.99 ng/mL , in female and male adolescent subjects , respectively ) . Elimination was biphasic , with an approximate terminal elimination half-life ( t(1/2 ) ) between 12.2 and 25.5 hours . Renal clearance was similar in adolescents and adults , being somewhat higher in female than male subjects . Frovatriptan was well tolerated with no serious or treatment-related adverse effects . In addition , there were no clinical ly significant changes in safety parameters . Overall , the pharmacokinetic profile of frovatriptan in adolescents ( 12 - 17 years ) is similar to that seen in adults , and dosing adjustments are unlikely to be needed OBJECTIVE The objective of this study was to determine the 1-year tolerability and efficacy of sumatriptan nasal spray ( NS ) at doses of 5 , 10 , and 20 mg for the treatment of acute migraine in adolescents . METHODS This was a prospect i ve , multicenter , open-label , 1-year , multiple-attack study . Adolescents ( aged 12 - 17 years ) with a > or = 6-month history of migraine with or without aura , 2 to 8 moderate or severe migraines per month , and a typical migraine duration of > or = 4 hours were eligible for participation . After initial treatment with sumatriptan 10 mg , the dose could be adjusted down to 5 mg or up to 20 mg at the investigator 's discretion to optimize tolerability or efficacy . Patients could treat an unlimited number of moderate or severe migraine attacks , provided there was a 24-hour headache-free period between treated attacks and a 2-hour period between doses of sumatriptan NS . A second dose of sumatriptan NS was available for headache recurrence 2 to 24 hours after initial treatment ; no more than 2 doses could be used within a 24-hour period . Adverse events , vital signs , electrocardiographic and physical findings , and laboratory variables were assessed . Headache response ( reduction of moderate/severe predose pain to mild/no pain ) and pain-free response ( reduction of moderate/severe predose pain to no pain ) were reported by patients 2 hours after dosing . RESULTS A total of 437 patients treated > or = 1 migraine ; 3272 total attacks were treated , with 3675 drug exposures ( mean , 1.1 dose/attack ) . Patients had a mean age of 14.1 years , 91 % were white , and 53 % were female . Seven patients used the 5-mg dose ; meaningful conclusions concerning this dose could not be made . Drug-related adverse events were reported in 33 % of attacks with the 10-mg dose and 31 % with the 20-mg dose ; most were related to taste disturbance . Adverse events did not increase with a second dose or over time . Four percent ( 16/437 ) of patients withdrew due to drug-related adverse events . One serious adverse event , a facial-nerve ischemic event ( 10-mg dose ) , was considered drug related . No drug-related changes in vital signs or electrocardiographic findings were observed . Headache response 2 hours after dosing was reported by 76 % of patients taking the 10-mg dose and 72 % of those taking the 20-mg dose . Pain-free response 2 hours after dosing was reported by 43 % and 40 % of patients in the 10- and 20-mg groups , respectively . CONCLUSIONS Based on these results , sumatriptan NS at doses of 10 and 20 mg was well tolerated and effective in the 1-year treatment of multiple migraine attacks in adolescents Oral sumatriptan is an effective acute treatment for migraine in adults , but its efficacy in children is still undetermined . Twenty-three children , aged 8.3 to 16.4 years , took both sumatriptan and placebo in a r and omized , double-blind , placebo-controlled , crossover trial . The primary endpoint was a ≥50 % decrease in pain intensity on a 100-mm visual analogue scale at 2 hours . Other endpoints of efficacy were pain intensity difference ( PID ) , showing pain relief at each time point ; summed pain intensity differences ( SPIDs ) , estimating overall pain relief ; and preference . Two hours after sumatriptan , 7 of 23 reached the primary endpoint , and after placebo , 5 of 23 ( difference 9 % , 95 % CI for difference , −21 to 38 % ; p = ns ) . Within 2 hours , the headache disappeared completely in 5 of 23 children after sumatriptan and in 2 of 23 children after placebo ( p = ns ) . Median PIDs were slightly better for sumatriptan between 0.5 and 4 hours ( p = ns ) . Median SPIDs increased almost identically up to 2 hours . Thereafter , median SPIDs for placebo remained practically constant , whereas for sumatriptan , the improvement continued . At 4 hours , the median SPID  for sumatriptan was 2.4 times as high as for placebo . However , the maximum differences between median SPIDs at 4 hours ( 38.5 , 95 % CI , −75.8 to 57.5 ; Wilcoxon signed rank test , p = 0.4 ) or at any other point were not statistically significant . Of the 23 children , 13 preferred sumatriptan and 2 placebo ( sign test , p = 0.004 ) . The failure of this and previous controlled studies suggests that the response of children  to sumatriptan may be different from adults Objective .—To assess the tolerability and effectiveness of nasal sumatriptan in the treatment of migraine in 5‐ to 12‐year‐old children OBJECTIVE To compare the efficacy and tolerability of sumatriptan nasal spray ( NS ) ( 5 , 20 mg ) versus placebo in the acute treatment of migraine in adolescent subjects . BACKGROUND Currently , no triptan is approved in the United States for the treatment of migraine in adolescent subjects ( 12 to 17 years ) . In a previous r and omized , placebo-controlled study of 510 adolescent subjects , sumatriptan NS at 5 , 10 , and 20 mg doses was well tolerated . However , the primary efficacy analysis for headache relief with 20 mg at 2 hours did not demonstrate statistical significance ( P = .059 ) . 
    Output:
    
Zolmitriptan and rizatriptan were superior to placebo in most studies .
Almotriptan demonstrated a high profile of tolerability .
All studies have reported a good triptan safety profile .
Triptans are an important option in the symptomatic treatment of childhood and adolescent migraine