MIGRAINES

Medication seems to combat severe menstrual headaches.

* THE QUESTION Migraines that accompany a woman's menstrual period generally last longer, are more severe and are harder to control than other such headaches. By anticipating the start of a menstrual migraine and taking frovatriptan, can women stave off these migraines?

* THIS STUDY randomly tested three treatment regimens -- 2.5 milligrams of frovatriptan once daily, the same dose twice a day, or a placebo -- on each of 443 women who had chronic and regular menstrual migraine attacks. All participants tried each regimen for six days, starting two days before the expected start of their menstrual migraine; they tried the other regimens in subsequent months. While taking the drug twice daily, 59 percent of the women had no migraines, compared with 48 percent while taking it once a day and 33 percent while taking the placebo. Women who still had headaches while taking the larger dose described them as less severe and shorter-lasting than migraines experienced while assigned to the other two regimens.

* WHO MAY BE AFFECTED BY THESE FINDINGS? Women with regular menstrual migraines, which are most common in middle age. About one in five adult women have migraines, and about half of them associate the headaches with menstruation.

* CAVEATS Women who cannot accurately predict the start of their menstrual periods may not achieve the same results. One of the authors of the study was a paid consultant for UCB Pharma, which markets frovatriptan; two other authors had received fees from the company.

* BOTTOM LINE Women who experience menstrual migraines may want to ask their doctors about frovatriptan.

* FIND THIS STUDY July 27 issue of Neurology; abstract available online at www.neurology.org.

* LEARN MORE ABOUT menstrual migraines at www.achenet.org/women and www.ninds.nih.gov.

breast cancer

Strengthening chemotherapy may not prevent relapses.

* THE QUESTION Breast cancer that has spread to the lymph nodes is more likely to recur. To reduce this risk, many women choose to undergo an intensified chemotherapy regimen. Does this work?

* THIS STUDY randomly assigned 605 women who had surgery for advanced breast cancer involving four or more lymph nodes to receive either conventional chemotherapy or a high-dose regimen that included a stem cell transplant. An average of five years later, survival rates were very similar: 62 percent for the high-dose group and 64 percent for the conventional group. Of those who got the higher dose, 57 percent had not relapsed, compared with 54 percent of the women who received conventional chemotherapy. Those undergoing high-dose chemotherapy sustained more toxic side effects but reported only slightly lower quality of life.

* WHO MAY BE AFFECTED BY THESE FINDINGS? Women with advanced breast cancer.

* CAVEATS The results could vary if different chemical agents were used or administered in a different order. The findings of this study conflict with those of earlier, non-randomized research.

* BOTTOM LINE Women with breast cancer may want to discuss expected outcomes with their doctors before deciding on a treatment strategy.

* FIND THIS STUDY July 21 issue of the Journal of the National Cancer Institute; abstract available online at http://jncicancerspectrum.oupjournals.org.

* LEARN MORE ABOUT breast cancer treatments at www.cancer.gov and www.cancer.org.

high cholesterol

Statins may help children with an inherited high-lipid disorder.

* THE QUESTION Statins have been proven effective in helping adults control cholesterol. Do they also work for children?

* THIS STUDY randomly assigned 214 children, aged 8 to 18, with inherited high cholesterol (known as familial hypercholesterolemia) to take either pravastatin (sold as Pravachol) or a placebo daily. After two years, so-called bad cholesterol (low-density lipoprotein) levels were down 24 percent in those who took pravastatin, compared with a 0.3 percent increase for the children who took the placebo. The pravastatin group's carotid artery walls also had become less thick, while the other group's thickened. No differences between the groups were found relative to growth, sexual maturation or hormone levels.

* WHO MAY BE AFFECTED BY THESE FINDINGS? Children with inherited high cholesterol, a condition that can lead to heart problems in later years.

* CAVEATS The study did not determine if pravastatin would be safe and effective if taken for more than two years. Whether results would be the same for children who have high cholesterol for reasons other than familial hypercholesterolemia remains unclear.

* BOTTOM LINE Parents of children with inherited high cholesterol may want to talk with a pediatrician about pravastatin.

* FIND THIS STUDY July 21 issue of the Journal of the American Medical Association; abstract available online at www.jama.com.

* LEARN MORE ABOUT cholesterol problems among children at http://familydoctor.org (search for "high cholesterol & kids") and http://kidshealth.org.

-- Linda Searing