Get access

Almotriptan Versus Rizatriptan in Patients With Migraine in Spain

Authors

  • Rogelio Leira MD, PhD,

    1. Servicio de Neurologia, Hospital Clínico Universitario, Santiago de Compostela, La Coruña (Dr. Leira); Valencia (Dr. Dualde); Madrid (Dr. del Barrio); Seville (Dr. Machuca); and the Departamento Médico, MSD España, Madrid (Dr. López-Gil), Spain.
    Search for more papers by this author
  • Elena Dualde PharmD,

    1. Servicio de Neurologia, Hospital Clínico Universitario, Santiago de Compostela, La Coruña (Dr. Leira); Valencia (Dr. Dualde); Madrid (Dr. del Barrio); Seville (Dr. Machuca); and the Departamento Médico, MSD España, Madrid (Dr. López-Gil), Spain.
    Search for more papers by this author
  • Horacio Del Barrio PharmD,

    1. Servicio de Neurologia, Hospital Clínico Universitario, Santiago de Compostela, La Coruña (Dr. Leira); Valencia (Dr. Dualde); Madrid (Dr. del Barrio); Seville (Dr. Machuca); and the Departamento Médico, MSD España, Madrid (Dr. López-Gil), Spain.
    Search for more papers by this author
  • Manuel Machuca PharmD, PhD,

    1. Servicio de Neurologia, Hospital Clínico Universitario, Santiago de Compostela, La Coruña (Dr. Leira); Valencia (Dr. Dualde); Madrid (Dr. del Barrio); Seville (Dr. Machuca); and the Departamento Médico, MSD España, Madrid (Dr. López-Gil), Spain.
    Search for more papers by this author
  • Arturo López-Gil MD, PhD,

    1. Servicio de Neurologia, Hospital Clínico Universitario, Santiago de Compostela, La Coruña (Dr. Leira); Valencia (Dr. Dualde); Madrid (Dr. del Barrio); Seville (Dr. Machuca); and the Departamento Médico, MSD España, Madrid (Dr. López-Gil), Spain.
    Search for more papers by this author
  • Spanish Group for the Study of Triptan Consumption in Community Pharmacies

    1. Servicio de Neurologia, Hospital Clínico Universitario, Santiago de Compostela, La Coruña (Dr. Leira); Valencia (Dr. Dualde); Madrid (Dr. del Barrio); Seville (Dr. Machuca); and the Departamento Médico, MSD España, Madrid (Dr. López-Gil), Spain.
    Search for more papers by this author

Address all correspondence to Dr. Arturo López-Gil, Departamento Médico, MSD España, c/Josefa Valcárcel 38, 28027 Madrid, Spain.

Abstract

Objectives.—To compare patient-reported use of rizatriptan 10 mg with that of almotriptan 12.5 mg per migraine attack (24 hours) in a Spanish population.

Methods.—One hundred twenty Spanish community pharmacies recruited patients with migraine to whom they had dispensed almotriptan and rizatriptan. No other selection criteria were used. Patients kept diaries for baseline pain intensity, the number of triptan tablets used, additional medication taken per attack, and their degree of satisfaction with the medication 2 hours after the initial dose. Patients recorded details for a maximum of 3 attacks. Analysis of variance or the Student t test and chi-squared or Fisher exact tests were used for univariate comparisons. A generalized estimating equation method was used to correct for within-subject variability. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were calculated.

Results.—One hundred twenty-six patients (85% women) recorded data for 318 migraine attacks. Rizatriptan was used to treat 122 attacks, almotriptan was used to treat 110 attacks, and a nontriptan medication was used in the initial treatment of 86 attacks. Triptan use (adjusted mean, 95% CI) per attack in this study was lower for rizatriptan (1.19 tablets; 95% CI, 1.06 to 1.32) than for almotriptan (1.43 tablets; 95% CI, 1.30 to 1.56; P= .003). The use of a triptan and additional medication per attack increased with baseline pain severity. Rizatriptan was used to treat more attacks with only one tablet (78%) than almotriptan (58%). Treatment of attacks with almotriptan was more than twice as likely to involve the use of more than one tablet per attack (24 hours) than those treated with rizatriptan (adjusted OR, 2.42; 95% CI, 1.37 to 4.30; P= .003). Patient satisfaction with treatment response at 2 hours was more than 2-fold greater for rizatriptan (85%) than for almotriptan (68%) (adjusted OR, 2.55; 95% CI, 1.11 to 5.87; P= .03).

Conclusions.—In this prescription-selected Spanish population, a significantly lower number of rizatriptan tablets were required to treat migraine attacks compared with almotriptan. Further, patients were more than twice as likely to use more than one tablet or additional medication (or both) for attacks treated with almotriptan than for those treated with rizatriptan. Although these data suggest that rizatriptan may be a more effective treatment for migraine than almotriptan, further randomized studies are required to confirm this conclusion.

Get access to the full text of this article

Ancillary