Rizatriptan (MAXALTTM, a registered trademark of Merck & Co. Inc.) is a selective 5-HT1B/1D receptor agonist with rapid oral absorption and early onset of action in the acute treatment of migraine. This randomized, open-label, crossover outpatient study assessed the preference of 481 patients for rizatriptan 10-mg rapidly disintegrating tablets versus sumatriptan (IMIGRANTM, a registered trademark of GlaxoWellcome PLC) 50-mg tablets in the treatment of a single migraine attack with each therapy. Almost twice as many patients preferred rizatriptan 10-mg rapidly disintegrating tablet to sumatriptan 50-mg tablet (64.3 vs. 35.7%, p ≤ 0.001). Faster relief of headache pain was the most important reason for the preference, cited by 46.9% of patients preferring rizatriptan and 43.4% of patients who preferred sumatriptan. Headache relief at 2 h was 75.9% with rizatriptan and 66.6% with sumatriptan (p ≤ 0.001), with rizatriptan being superior to sumatriptan within 30 min of dosing. Fifty-five percent of patients were pain free 2 h after rizatriptan, compared with 42.1% treated with sumatriptan (p ≤ 0.001), rizatriptan being superior within 1 h of treatment. Forty-one percent of patients taking rizatriptan were pain free at 2 h and had no recurrence or need for additional medication, compared to 32.3% of patients on sumatriptan. Rizatriptan was also superior to sumatriptan in terms of the proportions of patients with no nausea, phonophobia or photophobia, and patients with normal function 2 h after treatment intake (p < 0.05). More patients were (completely, very or somewhat) satisfied 2 h after treatment with rizatriptan (73.3%) than 2 h after treatment with sumatriptan (59.0%) (p ≤ 0.001). Additionally, 2 h after the dose, more patients found rizatriptan to be very convenient, convenient or somewhat convenient (87.2%) than they did sumatriptan (76.3%) (p ≤ 0.001). Both active treatments were well tolerated. The most common side effects with rizatriptan and sumatriptan were nausea (6.6 and 6.9% of patients, respectively), dizziness (6.1 and 5.8%) and somnolence (7.4 and 6.7%).

1.
Ahrens SP, Farmer MV, Williams DL, Willoughby E, Jiang K, Block GA, Visser WH: Efficacy and safety of rizatriptan wafer for the acute treatment of migraine. Rizatriptan Wafer Protocol 049 Study Group. Cephalalgia 1999;19:525&ndash;530.
2.
Goldstein J, Ryan R, Jiang K, Getson A, Norman B, Block GA, Lines C: Crossover comparison of rizatriptan 5 mg and 10 mg vs sumatriptan 25 mg and 50 mg in migraine. Headache 1998;38:737&ndash;747.
3.
Tfelt-Hansen P, Teall J, Rodriguez F, Giacovazzo M, Paz J, Malbecq W, Block GA, Reines SA, Visser WH: Oral rizatriptan versus oral sumatriptan: A randomised, comparative study in the acute treatment of migraine. Headache 1998;38:748&ndash;755.
4.
WHO Collaborating Centre for Drug Statistics Methodology, February 2000 (www.whocc.nmd.no).
5.
Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain. Headache Classification Committee of the International Headache Society. Cephalalgia 1988;8(suppl 7):1&ndash;96.
6.
Jones B, Kenward MG: Design and Analysis of Cross-Over Trials. London, Chapman and Hall, 1989.
7.
Kalbfleish JD, Prentice RL: Marginal likelihood based on Cox&rsquo;s regression life models. Biometrika 1973;60:267&ndash;268.
8.
Hartmaier SL, Santanello NC, Epstein RS, Silberstein SD: Development of a brief 24-hour migraine-specific quality of life questionnaire. Headache 1995;35:320&ndash;329.
9.
Santanello NC, Hartmaier SL, Epstein RS, Silberstein SD: Validation of a new quality of life questionnaire for acute migraine headache. Headache 1995;35:330&ndash;337.
10.
Adelman JU, Mannix LK, Von Seggern RL: Rizatriptan tablet versus wafer: Patient preference. Headache 2000;40:371&ndash;372.
11.
Teall J, Tuchman M, Cutler N, Gross M, Willoughby E, Smith B, Jiang K, Reines S, Block G: Rizatriptan (MAXALT) for the acute treatment of migraine and migraine recurrence. A placebo-controlled, outpatient study. Rizatriptan 022 Study Group. Headache 1998;38:281&ndash;287.
12.
Tfelt-Hansen P, Block G, Dahlof C, Diener HC, Ferrari MD, Goadsby PJ, Guidetti V, Jones B, Lipton RB, Massiou H, Meinert C, Sandrini G, Steiner T, Winter PB: Guidelines for controlled trials of drugs in migraine: Second edition. Cephalalgia 2000;20:765&ndash;786.
13.
Salonen R, Ashford EA, Gibbs M, Hassani H: Patient preference for oral sumatriptan 25 mg, 50 mg, or 100 mg in the acute treatment of migraine: A double-blind, randomized, crossover study. Sumatriptan Tablets S2CM11 Study Group. Int J Clin Pract Suppl 1999;105:16&ndash;24.
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