- Rimegepant, an investigational oral calcitonin gene-related peptide receptor antagonist, is safe and efficacious for treating migraine attacks.
Why this matters
- Triptans have limited efficacy, adverse effects, safety concerns in patients with cardiovascular disease.
- Compared with placebo group, rimegepant group more likely to be free at 2 hours from:
- Pain (19.6% vs 12.0%; absolute difference, 7.6 percentage points; P<.001>
- Most bothersome nonpain symptom (37.6% vs 25.2%; absolute difference, 12.4 percentage points; P<.001>
- Multicenter phase 3 randomized controlled trial among 1186 adults with ≥1-year history of migraine and 2-8 migraine attacks of moderate or severe intensity per month.
- Randomization: double-blind oral rimegepant vs placebo for single migraine attack.
- Main outcomes: freedom from pain, freedom from most bothersome nonpain symptom at 2 hours after dose.
- Funding: Biohaven Pharmaceuticals.
- Smaller, shorter-duration trial.
- Lack of an active comparator.
- Uncertain safety in patients having cardiovascular disease.