Comparison of rizatriptan and other triptans on stringent measures of efficacy.
OBJECTIVE
To compare the efficacy of oral rizatriptan 10 mg with oral doses of sumatriptan, naratriptan, and zolmitriptan on stringent outcome measures.


METHODS
Retrospective analysis of data from five randomized, placebo-controlled, double-masked clinical trials in which oral rizatriptan was directly compared with oral sumatriptan 100 mg (n = 772), 50 mg (n = 1116), 25 mg (n = 1183), naratriptan 2.5 mg (n = 413), and zolmitriptan 2.5 mg (n = 580) for the acute treatment of a moderate or severe migraine attack.


METHODS
Percentage of patients pain-free at 2 hours, symptom-free at 2 hours (no pain, nausea, photophobia, phonophobia, vomiting, or functional disability), 24-hour sustained pain-free (no headache at 2 hours, no recurrence, and no additional antimigraine medications for 24 hours).


RESULTS
More patients taking rizatriptan 10 mg were pain-free at 2 hours than were patients taking sumatriptan 100 mg (40% vs 33%, p = 0.019), sumatriptan 50 mg (40% vs 35%, p = 0.009), sumatriptan 25 mg (38% vs 27%, p < 0.001), naratriptan 2.5 mg (45% vs 21%, p < 0.001), and zolmitriptan 2.5 mg (43% vs 36%, p = 0.041). More patients taking rizatriptan 10 mg were symptom-free at 2 hours than were patients taking sumatriptan 100 mg (31% vs 22%, p = 0.002), sumatriptan 50 mg (33% vs 28%, p = 0.003), sumatriptan 25 mg (33% vs 24%, p < 0.001), naratriptan 2.5 mg (30% vs 11%, p < 0.001), and zolmitriptan 2.5 mg (31% vs 24%, p = 0.042). More patients taking rizatriptan 10 mg had a 24-hour sustained pain-free response than did patients taking sumatriptan 100 mg (27% vs 23%, p = 0.112), sumatriptan 50 mg (30% vs 26%, p = 0.015), sumatriptan 25 mg (27% vs 20%, p = 0.005), naratriptan 2.5 mg (29% vs 17%, p = 0.004), and zolmitriptan 2.5 mg (32% vs 24%, p = 0.013).


CONCLUSIONS
Oral rizatriptan 10 mg was more effective than oral sumatriptan, naratriptan, and zolmitriptan on stringent outcome measures of pain-free response at 2 hours, symptom-free response at 2 hours, and 24-hour sustained pain-free response.
Adelman
J U
JU
Headache Wellness Center, Greensboro, NC 27401, USA. jadelman@triad.rr.com
Lipton
R B
RB
Ferrari
M D
MD
Diener
H C
HC
McCarroll
K A
KA
Vandormael
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Lines
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CR
D000284:Administration, Oral; D006801:Humans; D007211:Indoles / Q000008:administration & dosage; D008881:Migraine Disorders / Q000188:drug therapy*; D023303:Oxazolidinones / Q000008:administration & dosage; D017060:Patient Satisfaction; D010880:Piperidines / Q000008:administration & dosage; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D017366:Serotonin Receptor Agonists / Q000008:administration & dosage*; D018170:Sumatriptan / Q000008:administration & dosage*; D014230:Triazoles / Q000008:administration & dosage*; D014363:Tryptamines
D007211:Indoles; D023303:Oxazolidinones; D010880:Piperidines; D017366:Serotonin Receptor Agonists; D014230:Triazoles; D014363:Tryptamines; C089750:zolmitriptan; C093622:rizatriptan; D018170:Sumatriptan; C106783:naratriptan