Within-patient consistency of response of rizatriptan for treating migraine

Objective: To determine the within-patient consistency of response for riza triptan, a 5-HT1B/1D receptor agonist for the acute treatment of migraine. Methods: Post hoc analysis was performed on data from a randomized, double- blind, placebo-controlled clinical trial. Four hundred seventy-three patien ts with migraine diagnosed according to the criteria of the International H eadache Society were randomly assigned to one of five sequence groups in wh ich each patient was scheduled to treat four separate moderate or severe mi graine attacks. Patients in four groups received 10 mg of rizatriptan for t hree of four attacks and placebo for the remaining attack; patients in the fifth group received 10 mg of rizatriptan for all four attacks. Headache se verity, functional disability, and associated migraine symptoms were measur ed immediately before dosing and at regular intervals up to 4 hours after t he dose. The analysis was based on efficacy at 2 hours after dosing, the la st time point before escape medications were allowed. The percentages of pa tients who responded in a specified number of attacks after treatment with rizatriptan were calculated. The analysis was descriptive, and no formal st atistical testing was performed. Results: Of the evaluable patients who tre ated three migraine attacks with 10 mg of rizatriptan (with an additional i nterspersed placebo-treated attack in most patients), 216 of 252 (86%) had pain relief(reduction of pain to mild or none), 122 of 252 (48%) were pain free, 211 of 250 (84%) had no nausea, 163 of 251 (65%) had no photophobia, 182 of 252 (72%) had no phonophobia, 136 of 249 (55%) had no functional dis ability, and 233 of 252 (92%) had no need for escape medications at 2 hours after dosing in at least. two of three attacks. Concdusion: The response t o 10 mg of oral rizatriptan within individual patients was consistent over three attacks on a range of measures.