OBJECTIVES: Pain is a defining symptom of migraine, and patients with migraine have identified rapid relief of pain as a critical attribute of acute migraine therapy. Other outcomes beyond pain that are important to the well-being of migraine sufferers include preserving functional ability and absence of migraine-associated symptoms (nausea, photophobia, and phonophobia).  No study to our knowledge has examined the relationship between rapid pain relief and other symptoms/outcomes associated with migraine. This study examined whether rapid relief of migraine pain is associated with improvement in other outcomes throughout the migraine, particularly self-reported functional ability, nausea, photophobia, phonophobia. METHODS: COMPASS (NCT01667679) was a multicenter, double-dummy, multi-attack crossover study with two 12-week double-blind periods comparing the investigational product AVP-825 (breath-powered intranasal delivery system containing 22mg sumatriptan powder) to 100mg oral sumatriptan. For this analysis, attacks (N=1041) were grouped based on when pain relief or pain freedom was achieved as follows: rapid relief within10-30min (47.4%), slow relief within 45-120min (35.3%, and no relief within120min (17.4%). Self-reported functional ability (disability score of 0-3) and presence of migraine-associated symptoms were examined for these groups. RESULTS: Migraine attacks with rapid pain relief following treatment achieved significantly lower disability at 120min compared to migraine attacks with slow relief or no relief. Average disability scores were 0.19, 0.41, and 2.04 in the rapid, slow, and no relief categories, respectively. The average area under the curve (AUC) disability score from 30-120min was also lower when rapid relief was achieved, with average AUC scores of 0.48, 1.42, and 2.04 respectively. Rates of migraine-associated symptoms, including nausea, photophobia, and phonophobia were lower for the group experiencing rapid relief compared with the slow relief and no relief groups.  CONCLUSIONS: Rapid relief of pain in episodic migraine is associated with better functional ability and fewer migraine-associated symptoms throughout the course of the migraine.