Migraine: dissolvable rimegepant offers rapid relief

  • Lancet

  • International Clinical Digest
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • Patients with acute migraine reported a greater decrease in moderate or severe pain and other symptoms within 2 hours of receiving orally disintegrating rimegepant compared with placebo.

Why this matters

Study design

  • Randomised, placebo-controlled, multicentre phase 3 study of 1466 participants with migraine randomly assigned to rimegepant (75 mg orally disintegrating tablet) or placebo. 
  • Funding: Biohaven Pharmaceuticals.

Key results

  • At 2 hours, orally disintegrating rimegepant vs placebo was associated with significant freedom from:
    • moderate and severe pain (21% vs 11%; P<.0001>
    • most bothersome pain (35% vs 27%; P=.0009). 
  • Rimegepant was superior in terms of:
    • pain relief and ability to function normally at 60 minutes,
    • freedom from pain and freedom from most bothersome symptoms at 90 minutes,
    • rescue medication use at 24 hours, and
    • sustained freedom from pain and pain relief from 2 to 48 hours.
  • The most common adverse events in both groups were nausea, urinary tract infection, and dizziness.

Limitations

  • Lack of an active comparator.

Coauthored with Antara Ghosh, PhD