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Migraine Treatment With Rizatriptan and Non-Triptan Usual Care Medications: A Pharmacy-Based Study


  • Roger Cady MD,

  • Vincent Martin MD,

  • James Adelman MD,

  • Merle Diamond MD,

  • Shiva Sajjan PhD,

  • X. Henry Hu MD, PhD

  • From Headache Care Center, Primary Care Network, Inc., Springfield, MO (Dr. Cady); Division of General Internal Medicine, University of Cincinnati, Cincinnati, OH (Dr. Martin); Headache Wellness Center, Greensboro, NC (Dr. Adelman); Diamond Headache Clinic, Chicago, IL (Dr. Diamond); and Outcomes Research & Management, Merck & Co., Inc., West Point, PA (Drs. Sajjan and Hu).

Address all correspondence to Dr. X. Henry Hu, Outcomes Research & Management, Merck & Co., Inc., PO Box 4, WP39-130, West Point, PA 19486.


Objective.—To compare the effectiveness of rizatriptan to other non-triptan medications in the relief of migraine headache in usual care settings.

Background.—Although rizatriptan has been shown to provide effective relief of migraine symptoms in clinical trials, limited data exist directly comparing its effectiveness with non-triptan medications.

Methods.—Migraineurs aged 18 to 55 who had been prescribed a new antimigraine drug (rizatriptan 10 mg or a selected class of non-triptan oral medications) were recruited to participate in the study through a national retail pharmacy chain. Participants completed a baseline questionnaire at the enrollment and reported their treatment experiences by filling out the treatment diary after using the newly prescribed medication. The treatment outcomes of patients receiving rizatriptan were compared with those receiving non-triptan medications. Logistic regression analysis was applied to test statistical significance with adjustment for potential confounding factors.

Results.—Of the 728 patients who entered the study, 693 (95.2%) completed the treatment diary. Patients treated with rizatriptan (192) and non-triptans (501) reported the following outcomes, respectively—onset of headache relief within 30 minutes post-dose: 25% versus 18%; self-defined significant headache relief within 2 hours post-dose: 71% versus 54%; pain free or mild pain at 2 hours post-dose: 58% versus 47%; completely symptom-free within 2 hours of post-dose: 32% versus 20%; return to usual activities within 2 hours post-dose: 39% versus 35%; and satisfied with treatment: 67% versus 55% (P < .05 in all comparisons with exception of returning to usual activities).

Conclusion.—Rizatriptan was significantly more effective than non-triptans in the relief of migraine headaches for patients obtaining prescribed migraine medications from a retail pharmacy. Additional studies at other usual care settings may be needed to confirm the findings.