A randomized doubled blinded trial of treatment with diamino-oxidase (DAO) in patients with migraine and deficit of enzyme’s activity

Histamine has been considerate as a chemical mediator of migraine. The degradation is done in two different pathways. One of the enzymes that allow this process is the diamino-oxidase (DAO).

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J. Izquierdoa, D. Mona, M. Lorenteb, L. Soler Singlaa.
a Hospital General de Catalunya, Sant Cugat del Vallès, Spain;b Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain

Abstract — WCN 2013

No: 1617
Topic: 8 — Headache

October 15, 2013Volume 333, Supplement 1, Pages e505–e506

Abstract

Background:

Histamine has been considerate as a chemical mediator of migraine. The degradation is done in two different pathways. One
of the enzymes that allow this process is the diamino-oxidase (DAO).

Objective:

The aim of this study is to identify the prevalence of the deficit in the activity of DAO in patients with migraine, and test the supplementation of this enzyme in a randomized controlled doubleblind trial.

Material and methods:

This was a randomized parallel-group controlled study. After a 1-month run-in, patients with migraine attacks/month between 4 and 14 were randomized 1:1 to placebo or DAO three times at day during one month. Primary outcome measures were diminution of hours of pain, and the use of antimigraine drugs.

Results:

We studied 137 patients with migraine, and find the deficit of DAO activity (b80 HDU/ml) in 119 (87%).One hundred patients were randomized and included in the intentionto-treat analysis. Between run-in and first month of treatment, the mean number of hours of pain decreases in both groups but with significant difference in the final control in the group treated with DAO compared with placebo (6,3 vs 5,1: p b 0.03). The use of the acute antimigraine drug was significantly reduced in the DAO but not in placebo group (p N 0.022). There were no adverse events in either group.

Conclusions:

Deficit in the activity of DAO is very prevalent in population with migraine. The supplementation with the enzyme is effective and safe as a preventive therapy for migraine.

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