Improvement in health-related quality of life with rizatriptan 10mg compared with standard migraine therapy

Objective: To compare the effects of rizatriptan and patients' usual migraine medication(s) on health-related quality of life. Design and Setting: The study was a non-blinded, parallel-group, extension trial in which patients who had completed a randomised, placebo-controlled trial of the treatment of migraine with rizatriptan at 23 study sites in the United States were randomly assigned in a 4 : 1 ratio either to rizatriptan or to standard care. Patients: 265 migraineurs, 18 to 65 years of age. Interventions: Patients received either rizatriptan 10mg or their usual migraine medication(s). Main Outcome Measures and Results: The main outcome measures were: (a) migraine-specific quality of life during the 24-hour period of an attack, as determined by the 24-Hour Migraine-Specific Quality-of-Life Questionnaire (24-HrMQoLQ), for attacks in the first month; (b) general health-related quality of life as determined by the eight domain scores and the Mental and Physical Component Scales of the Short Form Health Survey (SF-36) after 2, 6 and 12 months. The 24-HrMQoLQ domains were scored from 3 to 21, and the SF-36 from 0 to 100, higher scores indicating better performance for both instruments. Patients receiving rizatriptan had significantly better scores in all five domains of the 24-HrMQoLQ compared with patients receiving standard care. Mean scores (standard error) for the rizatriptan and usual care groups were, respectively: Work Functioning, 13.9 (0.4),12.5 (0.8), p = 0.05; Social Functioning, 13.6 (0.4), 11.8 (0.8), p = 0.015; Energy/Vitality, 13.7 (0.5), 11.6 (0.8), p < 0.01; Feelings/Concerns 13.3 (0.4), 10.6 (0.8), p < 0.001; and Migraine Symptoms 14.1 (0.4), 12.1 (0.7), p < 0.01. There was a trend for patients receiving rizatriptan to have higher scores on the Mental Component Scale of the SF-36: mean score (SE) 50.3 (0.6) for rizatriptan, 48.0 (1.1) for usual care, p = 0.068. There was no difference between the treatment groups in the Physical Component Scale: mean score (SE) 48.4 (0.6) for rizatriptan, 49.7 (1.1) for usual care, p = 0.202. Conclusion: Quality of life in the 24-hour period following a migraine attack was better in patients treated with rizatriptan 10mg than in patients treated with their usual migraine medication.