Preference comparison of rizatriptan ODT 10-mg and sumatriptan 50-mg tablet in migraine.
OBJECTIVE
To compare the proportion of patients who prefer rizatriptan orally disintegrating tablet (ODT) 10-mg to sumatriptan 50-mg tablet.


BACKGROUND
Migraineurs express treatment preference based on a variety of attributes including the speed of pain relief and medication formulation. Rizatriptan ODT is an orally disintegrating formulation of rizatriptan, a selective 5-HT1B/1D receptor agonist. This study was conducted to determine patient preference between rizatriptan ODT 10-mg and sumatriptan 50-mg tablet for the acute treatment of migraine.


METHODS
This was a multicenter, randomized, open-label, two-period crossover study conducted in the United States with 524 enrolled patients. Patients treated a single moderate or severe headache in each treatment period. Patients treated one migraine with either rizatriptan ODT 10-mg or sumatriptan 50-mg tablet, then treated a second migraine with the alternate therapy. Patients completed diary assessments at baseline, and 30, 45, 60, 90, and 120 minutes postdose and rated headache severity on a 4-point scale (0 = none, 1 = mild, 2 = moderate, and 3 = severe). At the final study visit following treatment of their second migraine, patients expressed preference for one of the two study medications by completing an interviewer-administered Global Preference Question and then responded to a self-administered series of questions to capture their most important reason for preferring one study medication over the other. Safety measurements were recorded through standard adverse experience reporting.


RESULTS
Three hundred eighty-six patients treated two migraine attacks. For those patients who expressed a preference for either rizatriptan ODT or sumatriptan (n = 374), the percentage of patients who preferred rizatriptan ODT 10-mg (57%, n = 213) was significantly greater than those who preferred sumatriptan 50-mg tablet (43%, n = 161) (P<.01). For those patients who treated two migraine attacks and had drug severity measures for both attacks (n = 384), a significantly greater percentage of patients reported pain relief after taking rizatriptan ODT than sumatriptan at the 45- and 60-minute time points (38% versus 29% and 58% versus 49%, respectively) (P<.01). In addition, a significantly greater percentage of patients taking rizatriptan ODT reported a pain-free status at the 60- and 120-minute time points (23% versus 17% [P<.05] and 60% versus 52% [P<.01], respectively). Both rizatriptan ODT and sumatriptan were well tolerated.


CONCLUSIONS
A significantly greater proportion of patients preferred rizatriptan ODT 10-mg to sumatriptan 50-mg tablet for the acute treatment of migraine. Efficacy and safety data are consistent with the preference findings.
Loder
E
E
Spaulding Rehabilitation Hospital, Boston, MA, USA.
Brandes
J L
JL
Silberstein
S
S
Skobieranda
F
F
Bohidar
N
N
Wang
L
L
Boyle
D
D
Kolodny
A
A
Guerra
F
F
Santanello
N
N
Johnson-Pratt
L
L
D000328:Adult; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D008297:Male; D008881:Migraine Disorders / Q000188:drug therapy*; D017366:Serotonin Receptor Agonists / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D018170:Sumatriptan / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D013607:Tablets; D016896:Treatment Outcome; D014230:Triazoles / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D014363:Tryptamines; D014662:Vasoconstrictor Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use
D017366:Serotonin Receptor Agonists; D013607:Tablets; D014230:Triazoles; D014363:Tryptamines; D014662:Vasoconstrictor Agents; C093622:rizatriptan; D018170:Sumatriptan