Further Evaluation of Rizatriptan in Menstrual Migraine: Retrospective Analysis of Long-term Data

Objective.—To determine the long‐term efficacy of oral rizatriptan 10‐mg wafers in the treatment of menstrual migraine attacks. Methods.—Data from an extension study where patients with migraine used rizatriptan 10 mg to treat moderate or severe migraine attacks occurring over periods of up to 6 mon...

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Published inHeadache Vol. 42; no. 9; pp. 917 - 923
Main Authors Silberstein, Stephen D., Massiou, Helene, McCarroll, Kathleen A., Lines, Christopher R.
Format Journal Article
LanguageEnglish
Published Boston, MA, USA Blackwell Science Inc 01.10.2002
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Abstract Objective.—To determine the long‐term efficacy of oral rizatriptan 10‐mg wafers in the treatment of menstrual migraine attacks. Methods.—Data from an extension study where patients with migraine used rizatriptan 10 mg to treat moderate or severe migraine attacks occurring over periods of up to 6 months were included in a retrospective analysis. Patients used a diary card to record details of each migraine attack and onset of menstruation. Attacks in women were classified as menstrual or nonmenstrual according to 3 time windows relative to onset of menstruation (day 0): −3 to +3 days (7‐day window), −2 to + 2 days (5‐day window), and 0 to +1 days (2‐day window). The analysis looked at the efficacy of rizatriptan 10 mg by menstrual category of attack for each definition on three measures: pain relief at 2 hours (reduction of pain to mild or none), pain free at 2 hours, 24‐hours sustained pain free (pain free at 2 hours with no headache recurrence and no use of additional medications from 2 to 24 hours). Results.—Ninety‐five women used rizatriptan 10 mg to treat a total of 1,839 attacks. The percentage of menstrual attacks was 30% for the –3 to +3 days definition, 23% for the −2 to +2 days definition, and 11% for the 0 to +1 days definition. Rizatriptan 10 mg was equally effective in menstrual and nonmenstrual migraine attacks regardless of the definition used. For example, using the −3 to +3 days definition, 78% of menstrual migraine attacks were relieved at 2 hours after dosing compared with 78% of nonmenstrual attacks. Pain relief rates for the other definitions were as follows: −2 to +2 days, menstrual  =  78%, nonmenstrual  =  78%; 0 to +1 days, menstrual  =  79%, and nonmenstrual  =  78%. No differences between menstrual and nonmenstrual attacks were found for the 2‐hour pain free and 24‐hour sustained pain free measures for any of the three definitions. Conclusion.—Rizatriptan 10‐mg wafers were equally effective in the treatment of menstrual and nonmenstrual migraine attacks occurring over 6 months, regardless of the precise definition of menstrual association used and even when the outcome criteria were very stringent. These data provide further evidence that triptans are effective treatments for menstrual migraine.
AbstractList Objective.-To determine the long-term efficacy of oral rizatriptan 10-mg wafers in the treatment of menstrual migraine attacks. Methods.-Data from an extension study where patients with migraine used rizatriptan 10 mg to treat moderate or severe migraine attacks occurring over periods of up to 6 months were included in a retrospective analysis. Patients used a diary card to record details of each migraine attack and onset of menstruation. Attacks in women were classified as menstrual or nonmenstrual according to 3 time windows relative to onset of menstruation (day 0): -3 to +3 days (7-day window), -2 to + 2 days (5-day window), and 0 to +1 days (2-day window). The analysis looked at the efficacy of rizatriptan 10 mg by menstrual category of attack for each definition on three measures: pain relief at 2 hours (reduction of pain to mild or none), pain free at 2 hours, 24-hours sustained pain free (pain free at 2 hours with no headache recurrence and no use of additional medications from 2 to 24 hours). Results.-Ninety-five women used rizatriptan 10 mg to treat a total of 1,839 attacks. The percentage of menstrual attacks was 30% for the -3 to +3 days definition, 23% for the -2 to +2 days definition, and 11% for the 0 to +1 days definition. Rizatriptan 10 mg was equally effective in menstrual and nonmenstrual migraine attacks regardless of the definition used. For example, using the -3 to +3 days definition, 78% of menstrual migraine attacks were relieved at 2 hours after dosing compared with 78% of nonmenstrual attacks. Pain relief rates for the other definitions were as follows: -2 to +2 days, menstrual=78%, nonmenstrual=78%; 0 to +1 days, menstrual=79%, and nonmenstrual=78%. No differences between menstrual and nonmenstrual attacks were found for the 2-hour pain free and 24-hour sustained pain free measures for any of the three definitions. Conclusion.-Rizatriptan 10-mg wafers were equally effective in the treatment of menstrual and nonmenstrual migraine attacks occurring over 6 months, regardless of the precise definition of menstrual association used and even when the outcome criteria were very stringent. These data provide further evidence that triptans are effective treatments for menstrual migraine.
Objective.—To determine the long‐term efficacy of oral rizatriptan 10‐mg wafers in the treatment of menstrual migraine attacks. Methods.—Data from an extension study where patients with migraine used rizatriptan 10 mg to treat moderate or severe migraine attacks occurring over periods of up to 6 months were included in a retrospective analysis. Patients used a diary card to record details of each migraine attack and onset of menstruation. Attacks in women were classified as menstrual or nonmenstrual according to 3 time windows relative to onset of menstruation (day 0): −3 to +3 days (7‐day window), −2 to + 2 days (5‐day window), and 0 to +1 days (2‐day window). The analysis looked at the efficacy of rizatriptan 10 mg by menstrual category of attack for each definition on three measures: pain relief at 2 hours (reduction of pain to mild or none), pain free at 2 hours, 24‐hours sustained pain free (pain free at 2 hours with no headache recurrence and no use of additional medications from 2 to 24 hours). Results.—Ninety‐five women used rizatriptan 10 mg to treat a total of 1,839 attacks. The percentage of menstrual attacks was 30% for the –3 to +3 days definition, 23% for the −2 to +2 days definition, and 11% for the 0 to +1 days definition. Rizatriptan 10 mg was equally effective in menstrual and nonmenstrual migraine attacks regardless of the definition used. For example, using the −3 to +3 days definition, 78% of menstrual migraine attacks were relieved at 2 hours after dosing compared with 78% of nonmenstrual attacks. Pain relief rates for the other definitions were as follows: −2 to +2 days, menstrual  =  78%, nonmenstrual  =  78%; 0 to +1 days, menstrual  =  79%, and nonmenstrual  =  78%. No differences between menstrual and nonmenstrual attacks were found for the 2‐hour pain free and 24‐hour sustained pain free measures for any of the three definitions. Conclusion.—Rizatriptan 10‐mg wafers were equally effective in the treatment of menstrual and nonmenstrual migraine attacks occurring over 6 months, regardless of the precise definition of menstrual association used and even when the outcome criteria were very stringent. These data provide further evidence that triptans are effective treatments for menstrual migraine.
Objective .—To determine the long‐term efficacy of oral rizatriptan 10‐mg wafers in the treatment of menstrual migraine attacks. Methods .—Data from an extension study where patients with migraine used rizatriptan 10 mg to treat moderate or severe migraine attacks occurring over periods of up to 6 months were included in a retrospective analysis. Patients used a diary card to record details of each migraine attack and onset of menstruation. Attacks in women were classified as menstrual or nonmenstrual according to 3 time windows relative to onset of menstruation (day 0): −3 to +3 days (7‐day window), −2 to + 2 days (5‐day window), and 0 to +1 days (2‐day window). The analysis looked at the efficacy of rizatriptan 10 mg by menstrual category of attack for each definition on three measures: pain relief at 2 hours (reduction of pain to mild or none), pain free at 2 hours, 24‐hours sustained pain free (pain free at 2 hours with no headache recurrence and no use of additional medications from 2 to 24 hours). Results .—Ninety‐five women used rizatriptan 10 mg to treat a total of 1,839 attacks. The percentage of menstrual attacks was 30% for the –3 to +3 days definition, 23% for the −2 to +2 days definition, and 11% for the 0 to +1 days definition. Rizatriptan 10 mg was equally effective in menstrual and nonmenstrual migraine attacks regardless of the definition used. For example, using the −3 to +3 days definition, 78% of menstrual migraine attacks were relieved at 2 hours after dosing compared with 78% of nonmenstrual attacks. Pain relief rates for the other definitions were as follows: −2 to +2 days, menstrual  =  78%, nonmenstrual  =  78%; 0 to +1 days, menstrual  =  79%, and nonmenstrual  =  78%. No differences between menstrual and nonmenstrual attacks were found for the 2‐hour pain free and 24‐hour sustained pain free measures for any of the three definitions. Conclusion .—Rizatriptan 10‐mg wafers were equally effective in the treatment of menstrual and nonmenstrual migraine attacks occurring over 6 months, regardless of the precise definition of menstrual association used and even when the outcome criteria were very stringent. These data provide further evidence that triptans are effective treatments for menstrual migraine.
To determine the long-term efficacy of oral rizatriptan 10-mg wafers in the treatment of menstrual migraine attacks.OBJECTIVETo determine the long-term efficacy of oral rizatriptan 10-mg wafers in the treatment of menstrual migraine attacks.Data from an extension study where patients with migraine used rizatriptan 10 mg to treat moderate or severe migraine attacks occurring over periods of up to 6 months were included in a retrospective analysis. Patients used a diary card to record details of each migraine attack and onset of menstruation. Attacks in women were classified as menstrual or nonmenstrual according to 3 time windows relative to onset of menstruation (day 0): -3 to +3 days (7-day window), -2 to + 2 days (5-day window), and 0 to +1 days (2-day window). The analysis looked at the efficacy of rizatriptan 10 mg by menstrual category of attack for each definition on three measures: pain relief at 2 hours (reduction of pain to mild or none), pain free at 2 hours, 24-hours sustained pain free (pain free at 2 hours with no headache recurrence and no use of additional medications from 2 to 24 hours).METHODSData from an extension study where patients with migraine used rizatriptan 10 mg to treat moderate or severe migraine attacks occurring over periods of up to 6 months were included in a retrospective analysis. Patients used a diary card to record details of each migraine attack and onset of menstruation. Attacks in women were classified as menstrual or nonmenstrual according to 3 time windows relative to onset of menstruation (day 0): -3 to +3 days (7-day window), -2 to + 2 days (5-day window), and 0 to +1 days (2-day window). The analysis looked at the efficacy of rizatriptan 10 mg by menstrual category of attack for each definition on three measures: pain relief at 2 hours (reduction of pain to mild or none), pain free at 2 hours, 24-hours sustained pain free (pain free at 2 hours with no headache recurrence and no use of additional medications from 2 to 24 hours).Ninety-five women used rizatriptan 10 mg to treat a total of 1,839 attacks. The percentage of menstrual attacks was 30% for the -3 to +3 days definition, 23% for the -2 to +2 days definition, and 11% for the 0 to +1 days definition. Rizatriptan 10 mg was equally effective in menstrual and nonmenstrual migraine attacks regardless of the definition used. For example, using the -3 to +3 days definition, 78% of menstrual migraine attacks were relieved at 2 hours after dosing compared with 78% of nonmenstrual attacks. Pain relief rates for the other definitions were as follows: -2 to +2 days, menstrual = 78%, nonmenstrual = 78%; 0 to +1 days, menstrual = 79%, and nonmenstrual = 78%. No differences between menstrual and nonmenstrual attacks were found for the 2-hour pain free and 24-hour sustained pain free measures for any of the three definitions.RESULTSNinety-five women used rizatriptan 10 mg to treat a total of 1,839 attacks. The percentage of menstrual attacks was 30% for the -3 to +3 days definition, 23% for the -2 to +2 days definition, and 11% for the 0 to +1 days definition. Rizatriptan 10 mg was equally effective in menstrual and nonmenstrual migraine attacks regardless of the definition used. For example, using the -3 to +3 days definition, 78% of menstrual migraine attacks were relieved at 2 hours after dosing compared with 78% of nonmenstrual attacks. Pain relief rates for the other definitions were as follows: -2 to +2 days, menstrual = 78%, nonmenstrual = 78%; 0 to +1 days, menstrual = 79%, and nonmenstrual = 78%. No differences between menstrual and nonmenstrual attacks were found for the 2-hour pain free and 24-hour sustained pain free measures for any of the three definitions.Rizatriptan 10-mg wafers were equally effective in the treatment of menstrual and nonmenstrual migraine attacks occurring over 6 months, regardless of the precise definition of menstrual association used and even when the outcome criteria were very stringent. These data provide further evidence that triptans are effective treatments for menstrual migraine.CONCLUSIONSRizatriptan 10-mg wafers were equally effective in the treatment of menstrual and nonmenstrual migraine attacks occurring over 6 months, regardless of the precise definition of menstrual association used and even when the outcome criteria were very stringent. These data provide further evidence that triptans are effective treatments for menstrual migraine.
To determine the long-term efficacy of oral rizatriptan 10-mg wafers in the treatment of menstrual migraine attacks. Data from an extension study where patients with migraine used rizatriptan 10 mg to treat moderate or severe migraine attacks occurring over periods of up to 6 months were included in a retrospective analysis. Patients used a diary card to record details of each migraine attack and onset of menstruation. Attacks in women were classified as menstrual or nonmenstrual according to 3 time windows relative to onset of menstruation (day 0): -3 to +3 days (7-day window), -2 to + 2 days (5-day window), and 0 to +1 days (2-day window). The analysis looked at the efficacy of rizatriptan 10 mg by menstrual category of attack for each definition on three measures: pain relief at 2 hours (reduction of pain to mild or none), pain free at 2 hours, 24-hours sustained pain free (pain free at 2 hours with no headache recurrence and no use of additional medications from 2 to 24 hours). Ninety-five women used rizatriptan 10 mg to treat a total of 1,839 attacks. The percentage of menstrual attacks was 30% for the -3 to +3 days definition, 23% for the -2 to +2 days definition, and 11% for the 0 to +1 days definition. Rizatriptan 10 mg was equally effective in menstrual and nonmenstrual migraine attacks regardless of the definition used. For example, using the -3 to +3 days definition, 78% of menstrual migraine attacks were relieved at 2 hours after dosing compared with 78% of nonmenstrual attacks. Pain relief rates for the other definitions were as follows: -2 to +2 days, menstrual = 78%, nonmenstrual = 78%; 0 to +1 days, menstrual = 79%, and nonmenstrual = 78%. No differences between menstrual and nonmenstrual attacks were found for the 2-hour pain free and 24-hour sustained pain free measures for any of the three definitions. Rizatriptan 10-mg wafers were equally effective in the treatment of menstrual and nonmenstrual migraine attacks occurring over 6 months, regardless of the precise definition of menstrual association used and even when the outcome criteria were very stringent. These data provide further evidence that triptans are effective treatments for menstrual migraine.
Author Silberstein, Stephen D.
Massiou, Helene
Lines, Christopher R.
McCarroll, Kathleen A.
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  surname: Lines
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Issue 9
Keywords Human
Nervous system diseases
Agonist
Menstruation
Prognosis
Antimigrainous agent
Migraine
Oral administration
Tryptamine derivatives
Cardiovascular disease
Serotonine receptor
Serotonin agonist
Long term
Cerebral disorder
Vascular disease
Chemotherapy
Pain
Treatment
Central nervous system disease
Adult
Female
Rizatriptan
Indole derivatives
Cerebrovascular disease
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References Ahrens SP, Farmer MV, Williams DL, et al. Efficacy and safety of rizatriptan wafer for the acute treatment of migraine. Cephalalgia. 1999;19: 525-530.
International Headache Society Clinical Trials Subcommittee. Guidelines for controlled trials of drugs in migraine: second edition. Cephalalgia. 2000;20: 765-786.
Johannes CB, Linet MS, Stewart WF, Celentano DD, Lipton RB, Szklo M. Relationship of headache to phase of the menstrual cycle among young women: a daily diary study. Neurology. 1995;45: 1076-1082.
Granella F, Sances G, Allais G, et al. Characteristics of menstrual and non-menstrual attacks in women with menstrually related migraine [abstract]. Cephalalgia. 2001;21: 263-264.
Silberstein SD, Massiou H, Le Jeunne C, Johnson-Pratt L, McCarroll KA, Lines CR. Rizatriptan in the treatment of menstrual migraine. Obstet Gynecol. 2000;96: 237-242.
Granella F, Sances G, Nanferrari C, Costa A, Martignoni E, Manzoni GC. Migraine without aura and reproductive life events: a clinical epidemiological study in 1300 women. Headache. 1993;33: 385-389.
Silberstein SD. The role of sex hormones in headache. Neurology. 1992;42(Suppl 2):37-42.
Massiou H, Silberstein SD, McCarroll KA, Allen C, Lines CR. Efficacy of rizatriptan in menstrual migraine: freedom from pain and associated symptoms at 2-h and 24-h sustained pain free status [abstract]. Cephalalgia. 2000;20: 343-344.
Loder E, Silberstein SD. Efficacy of zolmitriptan in the acute treatment of menstrually associated migraine [abstract]. Headache. 1999;39: 366.
Stewart WF, Lipton RB, Chee E, et al. Menstrual cycle and headache in a population sample of migraineurs. Neurology. 2000;55: 1517-1523.
Ferrari MD. Migraine. Lancet. 1998;351: 1043-1051.
Loder E. Menstrual migraine. Curr Treatm Opt Neurol. 2001;3: 189-200.
Headache Classification Committee of the International Headache Society. Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain. Cephalalgia. 1988;8(suppl 7):1-96.
Stewart WF, Lipton RB, Celentano DD, Reed ML. Prevalence of migraine in the United States: relation to age, income, race and other sociodemographic factors. JAMA. 1992;287: 64-69.
MacGregor EA, Chia H, Vohrah RC, Wilkinson M. Migraine and menstruation: a pilot study. Cephalalgia. 1990;10: 305-310.
MacGregor A. Migraine associated with menstruation. Funct Neurol. 2000;15(suppl 1):143-153
Granella F, Sances G, Messa G, De Marenis M, Manzoni GC. Treatment of menstrual migraine. Cephalalgia. 1997;17(suppl 20):35-38.
Salonen R, Saiers J. Sumatriptan is effective in the treatment of menstrual migraine: a review of prospective studies and retrospective analyses. Cephalalgia. 1999;19: 16-19.
Gross MLP, Barrie M, Bates D, Dowson A, Elrington G. The efficacy of oral sumatriptan in menstrual migraine-a prospective study [abstract]. Cephalalgia. 1995;15(suppl 4):227.
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References_xml – reference: MacGregor EA, Chia H, Vohrah RC, Wilkinson M. Migraine and menstruation: a pilot study. Cephalalgia. 1990;10: 305-310.
– reference: Salonen R, Saiers J. Sumatriptan is effective in the treatment of menstrual migraine: a review of prospective studies and retrospective analyses. Cephalalgia. 1999;19: 16-19.
– reference: Loder E, Silberstein SD. Efficacy of zolmitriptan in the acute treatment of menstrually associated migraine [abstract]. Headache. 1999;39: 366.
– reference: Johannes CB, Linet MS, Stewart WF, Celentano DD, Lipton RB, Szklo M. Relationship of headache to phase of the menstrual cycle among young women: a daily diary study. Neurology. 1995;45: 1076-1082.
– reference: Massiou H, Silberstein SD, McCarroll KA, Allen C, Lines CR. Efficacy of rizatriptan in menstrual migraine: freedom from pain and associated symptoms at 2-h and 24-h sustained pain free status [abstract]. Cephalalgia. 2000;20: 343-344.
– reference: Headache Classification Committee of the International Headache Society. Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain. Cephalalgia. 1988;8(suppl 7):1-96.
– reference: Loder E. Menstrual migraine. Curr Treatm Opt Neurol. 2001;3: 189-200.
– reference: Granella F, Sances G, Allais G, et al. Characteristics of menstrual and non-menstrual attacks in women with menstrually related migraine [abstract]. Cephalalgia. 2001;21: 263-264.
– reference: MacGregor A. Migraine associated with menstruation. Funct Neurol. 2000;15(suppl 1):143-153
– reference: Stewart WF, Lipton RB, Chee E, et al. Menstrual cycle and headache in a population sample of migraineurs. Neurology. 2000;55: 1517-1523.
– reference: Ferrari MD. Migraine. Lancet. 1998;351: 1043-1051.
– reference: Ahrens SP, Farmer MV, Williams DL, et al. Efficacy and safety of rizatriptan wafer for the acute treatment of migraine. Cephalalgia. 1999;19: 525-530.
– reference: Granella F, Sances G, Messa G, De Marenis M, Manzoni GC. Treatment of menstrual migraine. Cephalalgia. 1997;17(suppl 20):35-38.
– reference: Silberstein SD, Massiou H, Le Jeunne C, Johnson-Pratt L, McCarroll KA, Lines CR. Rizatriptan in the treatment of menstrual migraine. Obstet Gynecol. 2000;96: 237-242.
– reference: Stewart WF, Lipton RB, Celentano DD, Reed ML. Prevalence of migraine in the United States: relation to age, income, race and other sociodemographic factors. JAMA. 1992;287: 64-69.
– reference: Gross MLP, Barrie M, Bates D, Dowson A, Elrington G. The efficacy of oral sumatriptan in menstrual migraine-a prospective study [abstract]. Cephalalgia. 1995;15(suppl 4):227.
– reference: Granella F, Sances G, Nanferrari C, Costa A, Martignoni E, Manzoni GC. Migraine without aura and reproductive life events: a clinical epidemiological study in 1300 women. Headache. 1993;33: 385-389.
– reference: International Headache Society Clinical Trials Subcommittee. Guidelines for controlled trials of drugs in migraine: second edition. Cephalalgia. 2000;20: 765-786.
– reference: Silberstein SD. The role of sex hormones in headache. Neurology. 1992;42(Suppl 2):37-42.
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Snippet Objective.—To determine the long‐term efficacy of oral rizatriptan 10‐mg wafers in the treatment of menstrual migraine attacks. Methods.—Data from an extension...
Objective .—To determine the long‐term efficacy of oral rizatriptan 10‐mg wafers in the treatment of menstrual migraine attacks. Methods .—Data from an...
To determine the long-term efficacy of oral rizatriptan 10-mg wafers in the treatment of menstrual migraine attacks. Data from an extension study where...
Objective.-To determine the long-term efficacy of oral rizatriptan 10-mg wafers in the treatment of menstrual migraine attacks. Methods.-Data from an extension...
To determine the long-term efficacy of oral rizatriptan 10-mg wafers in the treatment of menstrual migraine attacks.OBJECTIVETo determine the long-term...
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SubjectTerms Administration, Oral
Adult
Biological and medical sciences
Cardiovascular system
Female
Humans
Medical sciences
menstruation
Menstruation - physiology
migraine
Migraine Disorders - drug therapy
Migraine Disorders - physiopathology
Pharmacology. Drug treatments
Retrospective Studies
rizatriptan
Serotonin Receptor Agonists - administration & dosage
Serotonin Receptor Agonists - therapeutic use
Triazoles - administration & dosage
Triazoles - therapeutic use
Tryptamines
Vasodilator agents. Cerebral vasodilators
Title Further Evaluation of Rizatriptan in Menstrual Migraine: Retrospective Analysis of Long-term Data
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https://onlinelibrary.wiley.com/doi/abs/10.1046%2Fj.1526-4610.2002.02214.x
https://www.ncbi.nlm.nih.gov/pubmed/12390621
https://www.proquest.com/docview/1560135630
https://www.proquest.com/docview/72514807
Volume 42
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