Acute Migraine Treatment With Rizatriptan in Real World Settings – Focusing on Treatment Strategy, Effectiveness, and Behavior

Authors

  • Henry Hu MD, PhD,

    1. From the Global Outcomes Research, Merck & Co., Inc., Whitehouse Station, NJ (H. Hu); Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (T. Kurth); Headache Care Center, Springfield, MO (R. Cady); Department of Epidemiology, Merck Research Laboratories, Upper Gwynedd, PA (N. Santanello); Global Scientific Affairs, Merck & Co., Inc., Whitehouse Station, NJ, and Department of Neurology, Albert Einstein College of Medicine, Bronx, NY (M.E. Bigal)
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  • Tobias Kurth MD, ScD,

    1. From the Global Outcomes Research, Merck & Co., Inc., Whitehouse Station, NJ (H. Hu); Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (T. Kurth); Headache Care Center, Springfield, MO (R. Cady); Department of Epidemiology, Merck Research Laboratories, Upper Gwynedd, PA (N. Santanello); Global Scientific Affairs, Merck & Co., Inc., Whitehouse Station, NJ, and Department of Neurology, Albert Einstein College of Medicine, Bronx, NY (M.E. Bigal)
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  • Roger Cady MD,

    1. From the Global Outcomes Research, Merck & Co., Inc., Whitehouse Station, NJ (H. Hu); Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (T. Kurth); Headache Care Center, Springfield, MO (R. Cady); Department of Epidemiology, Merck Research Laboratories, Upper Gwynedd, PA (N. Santanello); Global Scientific Affairs, Merck & Co., Inc., Whitehouse Station, NJ, and Department of Neurology, Albert Einstein College of Medicine, Bronx, NY (M.E. Bigal)
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  • Nancy Santanello MD, MS,

    1. From the Global Outcomes Research, Merck & Co., Inc., Whitehouse Station, NJ (H. Hu); Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (T. Kurth); Headache Care Center, Springfield, MO (R. Cady); Department of Epidemiology, Merck Research Laboratories, Upper Gwynedd, PA (N. Santanello); Global Scientific Affairs, Merck & Co., Inc., Whitehouse Station, NJ, and Department of Neurology, Albert Einstein College of Medicine, Bronx, NY (M.E. Bigal)
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  • Marcelo E. Bigal MD, PhD

    1. From the Global Outcomes Research, Merck & Co., Inc., Whitehouse Station, NJ (H. Hu); Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (T. Kurth); Headache Care Center, Springfield, MO (R. Cady); Department of Epidemiology, Merck Research Laboratories, Upper Gwynedd, PA (N. Santanello); Global Scientific Affairs, Merck & Co., Inc., Whitehouse Station, NJ, and Department of Neurology, Albert Einstein College of Medicine, Bronx, NY (M.E. Bigal)
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  • Conflict of Interest: Drs. Hu, Santanello, and Bigal are employees of Merck & Co., Inc. Dr. Kurth has received investigator-initiated research funding as Principal or Co-Investigator from Bayer AG, McNeil Consumer & Specialty Pharmaceuticals, Merck, the National Institutes of Health, and Wyeth Consumer Healthcare; he is a consultant to i3 Drug Safety and to WISHCON; he received honoraria from Organon for contributing to an expert panel and from Genzyme and Pfizer for educational lectures. Dr. Cady has received research funding from Merck & Co., Inc. and also serving as a consultant and on advisory board of Merck.

H. Hu, Global Outcomes Research, One Merck Drive, PO Box 100, WS2E-65, Whitehouse Station, NJ 08889, USA.

Abstract

Although randomized controlled trials (RCTs) are the gold standard for assessing efficacy of a drug intervention, because they are conducted in a highly selected group of patients, they do not necessarily reflect normal customary or optimized patient care. Accordingly, information from RCTs must be supplemented by outcomes research and by nonexperimental or quasi-experimental study designs. Herein, we discuss information that supplements the rigorous but sometimes rigid nature of RCTs in an effort to better understand the clinical utility of drug treatment for migraine with patient-centered outcomes in mind. We start by discussing several lessons we learned from RCTs on comparative triptan studies, followed by presenting data on outcomes studies for rizatriptan. We then briefly discuss migraine treatment behavior issues, including early treatment and adherence to treatment.

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