Selecting the preferred triptans

The objective was to identify a subset of preferred triptans from among available agents. A criterion of dominance was applied to statistically significant differences which emerged from a recent meta-analysis of placebo-controlled trials of the oral triptans in the treatment of acute migraine. Three alternatives—almotriptan 12.5 mg, eletriptan 80 mg and rizatriptan 10 mg—emerged as nondominated. These were not only superior on an individual basis, but, taken as a group, provided statistically significant superiority over the reference product (sumatriptan 100 mg) on all 5 treatment attributes studied. However, one of these, eletriptan 80 mg, is not approved for use as first line treatment, so the subset of preferred triptans for the treatment of acute migraine therefore comprises almotriptan 12.5 mg and rizatriptan 10 mg. Thus, almotriptan 12.5 mg and rizatriptan 10 mg are the preferred agents for the treatment of acute migraine.