Rizatriptan Effective for Migraine Relief
This viewpoint offers commentary on important clinical research in the area of pharmacy.
Bell CF, Foley KA, Barlas S, Solomon G, Hu XH
Clin Ther. 2006;28:872-880
Migraine headaches affect nearly 30 million individuals in the United States and are associated with significant economic and socials costs. Treatment for acute migraines includes both nonprescription and prescription medications. The effectiveness of migraine treatments has been studied in controlled clinical trials; however, little information is available regarding comparisons of therapies in the routine clinical practice settings. An open-label, multicenter study was conducted to compare the effectiveness of rizatriptan 10 mg and usual-care prescription migraine medications in a crossover fashion (Migraine Therapy Evaluation Protocol; MTEP).
Adults with migraines were recruited for the study. Patients were treated during 2 sequential migraine attacks with rizatriptan 10 mg and their previously prescribed migraine treatment in a crossover fashion. Patients were given a take-home treatment kit containing data collection information, rizatriptan, and a stopwatch to time onset of relief. The time to pain freedom was considered the primary endpoint. A total of 1489 patients were included in the analysis. Most patients (80.6%) treated both migraine attacks with oral triptans -- sumatriptan (48.9%); zolmitriptan (15.8%); eletriptan (12.9%); almotriptan (12.9%). Other medications included nonsteroidal anti-inflammatory drugs (5.4%), butalbital-containing compounds (4.3%), and isometheptene (3.4%).
The time to pain freedom was 76 minutes faster with rizatriptan compared with usual-care therapy; onset of pain relief was 22 minutes faster with rizatriptan. More patients reported being migraine free at 24 hours after initial treatment when migraines were treated with rizatriptan compared with usual-care treatments (80.1% vs 77%, P = .017). Failure to achieve pain freedom was more common with the usual-care treatments than with rizatriptan (5.9% vs 3.8%, P = .003). A post-hoc subgroup analysis revealed a shorter mean time to pain freedom with rizatriptan compared with other triptans (224.9 vs 287.1 minutes; P < .001) and nontriptans (208.9 vs 342.1 minutes, P < .001). A greater proportion of patients indicated satisfaction with rizatriptan compared with usual-care treatments (65.4% vs 57.7%, P < .001).
For many patients, the onset of a migraine can result in significant impairment that may necessitate time off from work or the inability to function in normal daily routines. Rapid and effective onset of pain relief is essential for these patients. The results of this study offer important insight into the differences of available treatments. Knowledge of the results of large studies such as this can be used to help guide treatment decisions.
Abstract
This viewpoint offers commentary on important clinical research in the area of pharmacy.
Bell CF, Foley KA, Barlas S, Solomon G, Hu XH
Clin Ther. 2006;28:872-880
Migraine headaches affect nearly 30 million individuals in the United States and are associated with significant economic and socials costs. Treatment for acute migraines includes both nonprescription and prescription medications. The effectiveness of migraine treatments has been studied in controlled clinical trials; however, little information is available regarding comparisons of therapies in the routine clinical practice settings. An open-label, multicenter study was conducted to compare the effectiveness of rizatriptan 10 mg and usual-care prescription migraine medications in a crossover fashion (Migraine Therapy Evaluation Protocol; MTEP).
Adults with migraines were recruited for the study. Patients were treated during 2 sequential migraine attacks with rizatriptan 10 mg and their previously prescribed migraine treatment in a crossover fashion. Patients were given a take-home treatment kit containing data collection information, rizatriptan, and a stopwatch to time onset of relief. The time to pain freedom was considered the primary endpoint. A total of 1489 patients were included in the analysis. Most patients (80.6%) treated both migraine attacks with oral triptans -- sumatriptan (48.9%); zolmitriptan (15.8%); eletriptan (12.9%); almotriptan (12.9%). Other medications included nonsteroidal anti-inflammatory drugs (5.4%), butalbital-containing compounds (4.3%), and isometheptene (3.4%).
The time to pain freedom was 76 minutes faster with rizatriptan compared with usual-care therapy; onset of pain relief was 22 minutes faster with rizatriptan. More patients reported being migraine free at 24 hours after initial treatment when migraines were treated with rizatriptan compared with usual-care treatments (80.1% vs 77%, P = .017). Failure to achieve pain freedom was more common with the usual-care treatments than with rizatriptan (5.9% vs 3.8%, P = .003). A post-hoc subgroup analysis revealed a shorter mean time to pain freedom with rizatriptan compared with other triptans (224.9 vs 287.1 minutes; P < .001) and nontriptans (208.9 vs 342.1 minutes, P < .001). A greater proportion of patients indicated satisfaction with rizatriptan compared with usual-care treatments (65.4% vs 57.7%, P < .001).
For many patients, the onset of a migraine can result in significant impairment that may necessitate time off from work or the inability to function in normal daily routines. Rapid and effective onset of pain relief is essential for these patients. The results of this study offer important insight into the differences of available treatments. Knowledge of the results of large studies such as this can be used to help guide treatment decisions.
Abstract