Efficacy and Safety of Rizatriptan Versus Standard Care During Long-term Treatment for Migraine

Authors

  • Gilbert A. Block MD, PhD,

    Corresponding author
    1. From Merck Research Laboratories, West Point, Penn (Drs. Block and Reines, Mr. Polis, and Ms. Smith) and the
      Address all correspondence to Dr. Gilbert A. Block, Merck Research Laboratories, BL2–5, West Point, PA 19486.
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  • Jerome Goldstein MD,

    1. San Francisco (Calif) Headache Clinic (Dr. Goldstein).
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  • Adam Polis MA,

    1. From Merck Research Laboratories, West Point, Penn (Drs. Block and Reines, Mr. Polis, and Ms. Smith) and the
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  • Scott A. Reines MD, PhD,

    1. From Merck Research Laboratories, West Point, Penn (Drs. Block and Reines, Mr. Polis, and Ms. Smith) and the
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  • Mary E. Smith BS,

    1. From Merck Research Laboratories, West Point, Penn (Drs. Block and Reines, Mr. Polis, and Ms. Smith) and the
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  • Rizatriptan Multicenter Study Groups


  • A complete list of the Rizatriptan Multicenter Study Groups appears at the end of this article.

Address all correspondence to Dr. Gilbert A. Block, Merck Research Laboratories, BL2–5, West Point, PA 19486.

Abstract

Rizatriptan is a novel, selective 5-HT1B/1D receptor agonist with a rapid onset of action after oral dosing for the acute treatment of migraine. We conducted a long-term (up to 1 year), multicenter, randomized study in 1831 patients treating more than 46 000 attacks to compare the efficacy and tolerability of rizatriptan 5 mg and 10 mg to standard care medications routinely used for the acute treatment of migraine attacks. Both doses of rizatriptan were highly effective, without evidence of tachyphylaxis. Rizatriptan 10 mg was consistently superior (P<0.05), both to the 5-mg dose and to standard care, in providing relief in 90% of attacks, with 50% pain-free by 2 hours after dosing. The most common dose-related adverse events were nausea, somnolence, and asthenia/fatigue. Based on this large, multicenter, long-term trial, rizatriptan is an important new oral agent for the acute treatment of migraine.

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