Preventive Medicine

Rimegepant Can Effectively Prevent Migraines

Rimegepant may be an effective preventative treatment for migraines, according to the results of a recent study.

The researchers conducted a multicenter, phase 2/3, randomized, double-blind, placebo-controlled trial to examine the efficacy of rimegepant for migraine prevention. Participants were recruited between November 2018 and August 2019 to be a part of the trial at 1 of the 92 included sites throughout the US.

Of the 747 total participants, 695 completed the study and were included in the efficacy analysis. All participants had at least a 1-year history of migraine and had participated in a 4-week observation period before being enrolled in the trial.

Out of those who were included in the final analysis, 348 participants were randomly assigned by an interactive web response system to receive rimegepant while 347 received placebo. Participants took either 75 mg of rimegepant or placebo orally every other day for 12 weeks.

The primary endpoint of the study was the change in the mean number of migraine days per month from the 4-week observational period to weeks 9 through 12 of the treatment phase. To be included in the efficacy analysis, participants must have received at least 1 dose of their randomized medication, have 14 days or more of data in the 4-week observation period, and have 14 days or more of data in 1 of the 4-week intervals in the treatment phase.

The results indicated that rimegepant was superior to placebo, as the change in the mean number of migraine days per month was −4.3 days (95% CI –4.8 to –3.9) for rimegepant and −3.5 days (–4.0 to –3.0) for placebo. Adverse events were reported in 36% of participants (n=133) independently in both groups. No patients included in the study died.

“Taken every other day, rimegepant was effective for preventive treatment of migraine,” the researchers concluded. “Tolerability was similar to that of placebo, and no unexpected or serious safety issues were noted.”

 

—Leigh Precopio

 

Reference:

Croop R, Lipton RB, Kudrow D, et al. Oral rimegepant for preventative treatment of migraine: a phase 2/3, randomized, double-blind, placebo-controlled trial. Lancet. 2020; 397(10268): 51-60. doi: 10.1016/S0140-6736(20)32544-7