Efficacy of Rizatriptan for Menstrual Migraine in an Early Intervention Model: A Prospective Subgroup Analysis of the Rizatriptan TAME (Treat A Migraine Early) Studies

Objective.— A prospective subgroup analysis of the TAME (Treat A Migraine Early) studies examined the efficacy of rizatriptan in patients treating a menstrual migraine attack. Methods.— Both TAME studies were randomized, placebo‐controlled, and double‐blind. Adults with migraine were assigned (2:1) to either rizatriptan 10‐mg tablet or placebo. Patients were instructed to treat within 1 hour of migraine onset and when the pain was mild. The primary endpoint was 2‐hour pain freedom. The diagnosis of menstrual migraine was established according to the revised 2004 International Headache Society (IHS) diagnostic criteria. Data from both studies were pooled for logistic regression analyses. A test for interaction was performed to compare rates of 2‐hour pain freedom between patients treating a menstrual and non‐menstrual attack. Results.— A total of 94 patients (63 in the rizatriptan group and 31 in the placebo group) met IHS criteria for menstrual migraine and treated a menstrual attack. The percentage of patients reporting 2‐hour pain freedom was significantly greater for rizatriptan than for placebo (63.5% vs 29.0%; odds ratio = 4.5; 95% confidence interval: 1.7, 11.9; P = .002) in those treating a menstrual attack. In those treating with rizatriptan, the percentage of patients with 2‐hour pain freedom did not statistically differ between those treating a menstrual or non‐menstrual migraine attack (63.5% vs 57.5%; P = .454). Conclusion.— Rizatriptan 10 mg was effective for the treatment of menstrual migraine in an early intervention model, as measured by 2‐hour pain freedom. Rates of 2‐hour pain freedom were comparable for patients treating menstrual and non‐menstrual migraine attacks with rizatriptan.