Both Acute Treatment of Migraine Attacks and Every-Other Day Dosing With Rimegepant Reduce Migraine Frequency 

Post hoc analysis of open-label study data shows that use of 75 mg rimegepant (Nurtec; Biohaven, New Haven, CT) as needed for acute treatment of migraine attacks also decreased the frequency of migraine attacks. Adults (n=1,044) in an open-label extension of a clinical trial (NCT03266588) who had been diagnosed with migraine at least 1 year before enrollment and had 6 or more monthly migraine days (MMD) were able to take up to 1 dose daily over the course of a year. 

Kaplan-Meier analyses of their migraine attack occurrences showed a median time to have at least 30% fewer attacks was 12 weeks. Median time to have headache frequency reduced by 50% of more was 32 weeks. Interquartile analysis showed an association of higher baseline MMD and longer time to 30% or 50% reduction of MMD. 

Among individuals using rimegepant as an acute treatment for 1 year, 80% preferred rimegepant to their previous migraine medications, 70% were satisfied with rimegepant, and 90% experienced clinical improvement relative to baseline

In the phase 2/3 clinical trial (NCT03732638) of rimegepant for prevention of migraine, people treated every other day with 75 mg rimegepant began experiencing MMD reduction as early as 1 week after starting treatment. Treatment with rimegepant every other day was superior to placebo for achieving a 50% or more reduction in mean MMDs (moderate or severe attacks) during weeks 9-12 (49% vs 41%, P=.0438). The change in the mean number of total MMDs during Weeks 1-12 was −4.3 with rimegepant vs −3.5 with placebo (P=.0099). 

Elyse Stock, MD, chief medical officer of Biohaven commented, "Nurtec ODT has changed the treatment paradigm for migraine with an easy to use, oral CGRP antagonist that is now indicated for both the acute treatment and prevention of migraine." 

Long-term safety studies showed that rimegepant was well tolerated and safe, including for individuals with cardiovascular disease risk factors. 

These data were preented at the 2021 International Headache Society – European Headache Federation Joint Congress virtually from September 8-12, 2021.