מתוך medicontext.co.il
WESTPORT, CT (Reuters Health) – For the treatment of moderate or severe migraines, rizatriptan (Merck & Co., Inc.) is more effective than other triptans according to measures of pain-free response at 2 hours, symptom-free response at 2 hours, and 24-hour sustained pain-free response, according to a report in the October 23rd issue of Neurology.
Dr. J. U. Adelman of the Headache Wellness Center in Greensboro, North Carolina and colleagues compared the efficacy of 10 mg oral rizatriptan with oral doses of sumatriptan, naratriptan, and zolmitriptan using "stringent" measures of outcome.
The team retrospectively evaluated data from five randomized, placebo-controlled, double-masked clinical trials in which oral rizatriptan was directly compared with other triptans for the treatment of moderate or severe migraine. The trials included oral sumatriptan at 100 mg, 50 mg, or 25 mg; naratriptan at 2.5 mg; and zolmitriptan 2.5 mg. Over 3000 subjects participated in the trials.
Patients taking rizatriptan had significantly higher pain-free responses at 2 hours than patients taking any other triptans. "The percentage of patients who were pain-free ranged from 38% to 45% for patients taking rizatriptan 10 mg and ranged from 21% to 36% for patients taking other triptans," the team explains. For those taking placebo, the response ranged from 8% to 10%.
The symptom-free response rate at 2 hours was also significantly higher among patients who were taking rizatriptan. The response rate ranged from 30% to 33% for those treated with rizatriptan 10 mg, and from 11% to 28% for those treated with other triptans. The response rates for those taking placebo ranged from 6% to 9%.
Patients taking rizatriptan had higher 24-hour sustained pain-free response rates than patients treated with other triptans. For patients treated with rizatriptan 10 mg, the response rate ranged from 27% to 32%. For those taking other triptans, the response rates ranged from 17% to 26%. For placebo-treated patients, the response rates ranged from 6% to 8%.
Adverse event rates ranged from 25% to 37% in patients taking rizatriptan and from 19% to 41% in those taking other triptans. "The most frequent types of adverse events were dizziness, asthenia and fatigue, somnolence, nausea, and dry mouth," Dr. Adelman and colleagues report.
The investigators in this study were either paid consultants or employees of Merck, which provided the research funding.
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