***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Rizatriptan is a potent , oral , 5-HT1B/1D agonist with more rapid absorption and higher bioavailability than oral sumatriptan . It was postulated that this would result in more rapid onset of effect . This r and omized , double-blind , triple-dummy , parallel-groups study compared rizatriptan 5 mg , rizatriptan 10 mg , sumatriptan 100 mg , and placebo in 1268 out patients treating a single migraine attack .  Headache relief rates after rizatriptan 10 mg were consistently higher than sumatriptan at all time points up to 2 hours , with significance at 1 hour ( 37 % versus 28 % , P = 0.010 ) . All active agents were significantly superior to placebo with regard to headache relief and pain freedom at 2 hours ( P < or = 0.001 ) . The primary efficacy endpoint of time to pain relief through 2 hours demonstrated that , after adjustment for age imbalance , rizatriptan 10 mg had earlier onset than sumatriptan 100 mg ( P = 0.032 ; hazard ratio 1.21 ) . Rizatriptan 10 mg was also superior to sumatriptan on pain-free response ( P = 0.032 ) , reduction in functional disability ( P = 0.015 ) , and relief of nausea at 2 hours ( P = 0.010 ) . Significantly fewer drug-related clinical adverse events were reported after rizatriptan 10 mg ( 33 % , P = 0.014 ) compared with sumatriptan 100 mg ( 41 % ) . We conclude that rizatriptan 10 mg has a rapid onset of action and relieves headache and associated symptoms more effectively than sumatriptan 100 mg OBJECTIVE To evaluate the impact of sumatriptan succinate injection compared with placebo on productivity loss during a migraine attack in the workplace . DESIGN R and omized , double-blind , placebo-controlled , parallel-group clinical trial . SETTING Fifteen clinical centers in the United States . PATIENTS One hundred thirty-five patients 18 years and older diagnosed as having migraine according to International Headache Society criteria . INTERVENTIONS Patients self-administered sumatriptan injection ( 6 mg ) or matching placebo to treat a moderate or severe migraine occurring within the first 4 hours of a minimum 8-hour work shift . MAIN OUTCOME MEASURES Mean productivity loss 2 hours after dosing and across the work shift ; percentages of patients returning to normal work performance within 2 hours after dosing and across the work shift ; percentages of patients experiencing headache relief ( reduction of moderate or severe predose pain to mild or no pain ) 1 and 2 hours after dosing . RESULTS Mean productivity loss was significantly ( P < or = .002 ) lower in the sumatriptan group compared with the placebo group both during the 2-hour postdose period ( sumatriptan , 39 minutes ; placebo , 54 minutes ) and across the work shift ( sumatriptan , 86 minutes ; placebo , 168 minutes ) . Significantly ( P<.001 ) greater percentages of patients in the sumatriptan group compared with the placebo group returned to normal work performance by 2 hours after dosing ( sumatriptan , 52 % ; placebo , 9 % ) and across the work shift ( sumatriptan , 66 % ; placebo , 18 % ) . Significantly ( P < or = .001 ) greater percentages of patients in the sumatriptan group compared with the placebo group experienced headache relief 1 hour after dosing ( sumatriptan , 69 % ; placebo , 18 % ) and 2 hours after dosing ( sumatriptan , 79 % ; placebo , 32 % ) . CONCLUSION Sumatriptan reduced migraine-associated productivity loss during a minimum 8-hour work shift by approximately 50 % compared with placebo and alleviated headache in more than three fourths of patients Overemphasis on hypothesis testing-- and the use of P values to dichotomise significant or non-significant results --has detracted from more useful approaches to interpreting study results , such as estimation and confidence intervals . In medical studies investigators are usually interested in determining the size of difference of a measured outcome between groups , rather than a simple indication of whether or not it is statistically significant . Confidence intervals present a range of values , on the basis of the sample data , in which the population value for such a difference may lie . Some methods of calculating confidence intervals for means and differences between means are given , with similar information for proportions . The paper also gives suggestions for graphical display . Confidence intervals , if appropriate to the type of study , should be used for major findings in both the main text of a paper and its abstract Rizatriptan wafer is a 5HT1B/1D agonist for use in the acute treatment of migraine . It is a freeze-fried formulation , approved for oral administration , which dissolves on the tongue and is swallowed with saliva . In this study the efficacy of sublingually administered rizatriptan 10-mg wafer was evaluated in a r and omized , double-blind , placebo-controlled , out-patient study involving 39 migraineurs . Patients were instructed to treat a migraine at the onset of pain in order to evaluate time of onset of pain relief and pain relief at 1 h. The average time to onset of relief was 25 min for patients treated with rizatriptan wafer and 27 min for patients treated with placebo . At 1 h , 50 % of the patients receiving rizatriptan wafer and 50 % of the patients receiving placebo experienced significant relief . Implication s and potential reasons for a high placebo response are discussed We assessed the quality of assessment and reporting of adverse effects in r and omized , double-blind clinical trials of single-dose acetaminophen or ibuprofen compared with placebo in moderate to severe postoperative pain . Reports were identified by systematic search ing of a number of bibliographic data bases ( e.g. , MEDLINE ) . Information on adverse effect assessment , severity and reporting , patient withdrawals , and anesthetic used was extracted . Compliance with former guidelines for adverse effect reporting was noted . Fifty-two studies were included ; two made no mention of adverse effects . No method of assessment was given in 19 studies . Twenty trials failed to report the type of anesthetic used , eight made no mention of patient withdrawals , and nine did not state the severity of reported adverse effects . Only two studies described the method of assessment of adverse effect severity . When all adverse effect data were pooled , significantly more adverse effects were reported with active treatment than with placebo . For individual adverse effects , there was no difference between active ( acetaminophen 1000 mg or ibuprofen 400 mg ) and placebo ; the exception was significantly more somnolence/drowsiness with ibuprofen 400 mg . Ninety percent of trials reporting somnolence/drowsiness with ibuprofen 400 mg were in dental pain . All studies published after 1994 complied with former guidelines for adverse effect reporting . Different methods of assessing adverse effects produce different reported incidence : patient diaries yielded significantly more adverse effects than other forms of assessment . We recommend guidelines for reporting adverse effect information in clinical trials MK-462 is a potent , selective 5HT1D receptor agonist which may be useful in treating acute migraine . We conducted a double-blind placebo-controlled inpatient study to assess the preliminary efficacy and safety of oral doses of MK-462 20 mg ( n = 8) and 40 mg ( n = 36 ) vs placebo ( n = 21 ) , administered to 65 male and post-menopausal female migraine patients aged 22–51 with moderate or severe migraine headache . Headache severity and functional disability were measured at 0.5 , 1 , 1.5 , and 2 h post-dose . The 20 mg dose was well tolerated and 4/8 patients obtained relief in headache severity at the 2 h time point . The 40 mg dose was well tolerated and was significantly ( p < 0.05 ) superior to placebo at the 1.5 and 2 h time points ( with 27/36 or 75 % obtaining relief at 2 h compared to 7/21 or 33 % for placebo ) . Adverse events occurred in 50 % of patients on 20 mg MK-462 , 72 % of those on 40 mg MK-462 , and in 52 % of placebo-treated subjects . The most common adverse events associated with MK-462  were drowsiness ( 20 mg 12 % ; 40 mg 44 % ; placebo 24 % ) , dry mouth ( 10 mg 36 % ; placebo 19 % ) , and lightheadedness/dizziness ( 40 mg 17 % ; placebo 10 % ) . Based on these preliminary results , MK-462 appears worthy of continued study for the treatment of acute migraine The efficacy and tolerability of rizatriptan ( MAXALT ™ ) and zolmitriptan ( ZOMIG ™ ) were compared in a r and omized , double – blind , double – dummy , stratified ( on prior use of rizatriptan and /or zolmitriptan ) , placebo – controlled , single attack study in 766 patients .  Rizatriptan tended to provide freedom from pain sooner than zolmitriptan ( hazard ratio 1.26 , P = 0.075 ) , acting within 60 min following dosing . More patients were pain free at 2 h on rizatriptan than on zolmitriptan ( 43.2 % vs. 35.6 % , P = 0.041 ) , while headache relief at 2 h was similar ( 70.5 % vs. 66.8 % ) . At 2 h , fewer patients on rizatriptan  had symptoms of photophobia ( 35.6 % vs. 43.5 % , P = 0.029 ) and nausea ( 25.2 % vs. 32.5 % , P = 0.046 ) , and more patients on rizatriptan had normal function ( 45.4 % vs. 37.0 % , P = 0.025 ) than zolmitriptan  . Headache recurred in 28 % of patients taking rizatriptan , 29 % taking zolmitriptan and 26 % taking placebo . Both active treatments were effective compared to placebo and were well tolerated . The most common side – effects with rizatriptan  were asthenia/fatigue , somnolence and dizziness , while the most common side – effects with zolmitriptan were asthenia/fatigue and dizziness Rizatriptan ( MAXALTTM , a registered trademark of Merck & Co. Inc. ) is a selective 5-HT1B/1D receptor agonist with rapid oral absorption and early onset of action in the acute treatment of migraine . This r and omized , open-label , crossover outpatient study assessed the preference of 481 patients for rizatriptan  10-mg rapidly disintegrating tablets versus sumatriptan ( IMIGRANTM , a registered trademark of GlaxoWellcome PLC ) 50-mg tablets in the treatment of a single migraine attack with each therapy . Almost twice as many patients preferred rizatriptan 10-mg rapidly disintegrating tablet to sumatriptan 50-mg tablet ( 64.3 vs. 35.7 % , p ≤ 0.001 ) . Faster relief of headache pain was the most important reason for the preference , cited by 46.9 % of patients preferring rizatriptan and 43.4 % of patients who preferred sumatriptan  . Headache relief at 2 h was 75.9 % with rizatriptan and 66.6 % with sumatriptan ( p ≤ 0.001 ) , with rizatriptan being superior to sumatriptan within 30 min of dosing . Fifty-five percent of patients were pain free 2 h after rizatriptan , compared with 42.1 % treated with sumatriptan ( p ≤ 0.001 ) , rizatriptan being superior within 1 h of treatment . Forty-one percent of patients taking rizatriptan were pain free at 2 h and had no recurrence or need for additional medication , compared to 32.3 % of patients on sumatriptan . Rizatriptan was also superior to sumatriptan in terms of the proportions of patients with no nausea , phonophobia or photophobia , and patients with normal function 2 h after treatment intake ( p < 0.05 ) . More patients were ( completely , very or somewhat ) satisfied 2 h after treatment with rizatriptan ( 73.3 % ) than 2 h after treatment with sumatriptan ( 59.0 % ) ( p ≤ 0.001 ) . Additionally , 2 h after the dose , more patients found rizatriptan to be very convenient , convenient or somewhat convenient ( 87.2 % ) than they did sumatriptan ( 76.3 % ) ( p ≤ 0.001 ) . Both active treatments were well tolerated . The most common side effects with rizatriptan and sumatriptan were nausea ( 6.6 and 6.9 % of patients , respectively ) , dizziness ( 6.1 and 5.8 % ) and somnolence ( 7.4 and 6.7 % ) A vali date d migraine-specific question naire ( 24-h Migraine Quality of Life Question na 
    Output:
    
A dose response was seen for the main outcomes .
REVIEW ER 'S CONCLUSIONS Rizatriptan 5 mg and 10 mg are effective in treating acute migraine , with a dose-related increase in efficacy