Rizatriptan vs. other Triptans on Stringent Measures of Efficacy in Migraine Patients

20 Jun, 22

Introduction

For better evaluation of the efficacy of an anti-migraine drug, various stringent measures such as; pain-free and 24-hour sustained pain-free response should be taken into account. To capture various migraine-associated symptoms such as nausea, photophobia, etc, a measure of symptom-free response at 2 hours has also been proposed.

Aim

To compare the efficacy of oral rizatriptan 10 mg vs. oral doses of sumatriptan, naratriptan, and zolmitriptan on various stringent outcome measures

Patient Profile

Outpatients with a 6-month history of migraine with or without aura (age ≥18 years)
All patients typically experienced one-to-eight attacks per month

Methods

Study Design

A Retrospective analysis of five randomized, placebo-controlled, double-masked clinical trials that compared oral rizatriptan 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.

Outcomes

Pain-free response at 2 hours
Symptom-free response at 2 hours (no pain, nausea, photophobia, phonophobia, vomiting, or functional disability)
24-hour sustained pain-free response (no headache at 2 hours, no recurrence, and no additional antimigraine medications for 24 hours)

Results

Mean age of the study population was 40 years.
A higher proportion of patients treated with rizatriptan vs. other triptans remained pain-free at 2 hours (Fig. 1)

Fig. 1: Proportion of patients remaining pain-free at 2 hours

A higher proportion of patients treated with rizatriptan vs. other triptans remained symptom-free at 2 hours (Fig. 2)

Fig. 2 Proportion of patients remaining symptom-free at 2 hours

A higher proportion of patients treated with rizatriptan 10 mg vs. other triptans achieved a 24-hour sustained pain-free response (Fig. 3).

Fig. 3: Proportion of patients achieving a 24-hour sustained pain-free response

All triptans were generally well-tolerated. All the adverse events that occurred were typically mild-to-moderate in severity and short-lasting.

Conclusions

Oral rizatriptan 10 mg was more effective than oral sumatriptan, naratriptan, and zolmitriptan in terms of stringent outcome measures of pain-free response at 2 hours, symptom-free response at 2 hours, and 24-hour sustained pain-free response.

Neurology 2001; 57:1377–1383.