Subcutaneous Dihydroergotamine vs Subcutaneous Sumatriptan-Reply

In reply The first double-blind randomized study directly comparing subcutaneous dihydroergotamine with subcutaneous sumatriptan in the treatment of acute migraine1clearly describes the treatment groups with the main outcome measures of pain relief and recurrence of successfully treated headaches emphasized. The conclusions of this article note that the "onset of relief with sumatriptan was more rapid, but by 3 hours dihydroergotamine and sumatriptan were equally efficacious" and "relief with dihydroergotamine was more sustained." Headache resolution was noted by both graphics and narrative to be 56.6% for the dihydroergotamine group and 78% for the sumatriptan group at 1 hour, and at 2 hours headache relief was 73% and 85%, respectively, which statistically significantly favored the sumatriptan group in the first 2 hours. Our selection of the 2-hour evaluation point in the abstract is consistent with the guidelines for controlled trials of "drugs in migraine"2that recommends, "Number of migraine