Data from a new study funded by GlaxoSmithKline indicates that migraine sufferers experience gastric stasis, or the delayed emptying of the stomach, both during and outside of a migraine attack, and that contrary to previous belief, gastric stasis did not worsen during an acute attack. This data may suggest that migraine sufferers are physiologically different in this regard than non-migraine sufferers. In addition, the data may also yield key clinical insights as the presence of gastric stasis, a physiologic phenomenon previously thought to only occur in migraine patients during an acute attack, may interfere with patients getting fast pain relief.
Gastric stasis is a common occurrence in migraine sufferers that can slow the disintegration and absorption of medicines in the stomach, and potentially limit the efficacy of medicine that is swallowed. This study shows that gastric stasis appears to be a feature of the disease (migraine) rather than an event that is triggered during an acute attack, states a GSK release.
"This new data provides important insights about migraine sufferers and affirms the importance of considering gastric stasis in treating these patients," said Sheena Aurora, director of the Swedish Headache Centre in Seattle.
The single-centre study comprised ten migraine sufferers, all with history of migraine with aura, and ten non-migrainous controls used gastric scintigraphy to measure gastric emptying during migraine. All migraine sufferers had migraine that matched International Headache Society (IHS) criteria and were sensitive to visual migraine triggers. For migrainous subjects, migraines were induced with visual triggers, and all subjects fasted overnight and were given a meal containing a radiopharmaceutical agent. Imaging of all subjects began immediately after the meal and within minutes of migraine induction. Images were acquired continuously for two hours for all subjects. Those with migraine were monitored for four hours to better measure any abnormality.
Endpoints were time to half emptying of the stomach and the percentage of radioactive material remaining at 2 hours in the stomach. Time to half emptying was delayed during the migraine (78%) and between migraines (80%). Gastric stasis was less pronounced during the migraine at approximately 150 minutes compared to between migraines at approximately 190 minutes. There was significant delay experienced in migrain sufferers compared to non-migraine controls at approximately 190 minutes to approximately 112 minutes. The data were replicated in percentage of radioactive material remaining in the stomach at two hours.