Migraine treatment outcomes with rizatriptan in triptan-naive patients: A naturalistic study

Background: The 5-hydroxytryptamine(1B/1D), agonists, or triptans, are the newest class of drugs to become available for the acute treatment of migrai ne. The class currently includes sumatriptan, zolmitriptan, naratriptan, an d rizatriptan. The efficacy of rizatriptan in the acute treatment of migrai ne has been established against placebo and other oral triptans in controll ed comparative trials. Objective: The US Migraine Assessment Protocol (USMAP) collected data on th e use of rizatriptan in a naturalistic setting reflecting clinical practice , This paper presents results for patients enrolled in the USMAP study who had never taken a triptan before the study. Methods: At enrollment, 216 patients completed a questionnaire describing t heir responses to their current nontriptan medications. They were then give n specially packaged samples of 4 standard 10-mg rizatriptan tablets and 4 orally disintegrating 10-mg, rizatriptan tablets (wafers) and were asked to take a different formulation for each of their next 2 attacks, the sequenc e to be at their discretion. Within similar to 24 hours after taking rizatr iptan, patients were to call a toll-free number to report their responses t o rizatriptan using an interactive voice-response system. Results: Within 2 hours after initial dosing of rizatriptan, significantly more patients taking either the rizatriptan tablet or the rizatriptan wafer reported onset of pain relief, had become largely symptom free, and were a ble to resume usual activities compared with their baseline responses to no ntriptans (P < 0.05). In addition, compared with their baseline responses t o nontriptans, significantly more patients taking either rizatriptan formul ation had mild or no pain 2 hours after dosing (P < 0.05). More than twice as many patients taking the rizatriptan tablets or wafers were either somew hat or very satisfied with the medication compared with their satisfaction with nontriptans (P < 0.05). Conclusions: In the naturalistic setting of this study, migraineurs who had not previously taken a triptan medication reported more rapid relief of pa in, more effective pain relief, and more rapid resumption of normal activit ies when taking rizatriptan tablets or wafers than when taking a nontriptan medication. Patients dissatisfied with their current nontriptan migraine t herapy may benefit from treatment with rizatriptan.