Rimegepant reduces migraine symptoms through 1 year of treatment

Rimegepant reduces the number of monthly migraine days in patients with migraine with or without aura and offers high treatment satisfaction, according to data from an analysis totalling over 1,000 patients.

Dr Shengyuan Yu (PLA General Hospital, China) and colleagues presented results from 2 uncontrolled, open-label, phase 2 trials in patients with acute migraine enrolled in the US (NCT03266588) and China (NCT05371652) who received rimegepant up to 75 mg daily over 52 weeks [1]. The trials enrolled adults with a history of migraine lasting longer than 1 year (with or without aura) and attacks lasting between 4–72 hours. The pooled analysis included patients with at least 6 monthly migraine days prior to the start of rimegepant treatment.

In total, 1,288 trial participants were included in the analysis (n=1,052 from the US, n=236 from China). The mean age of the cohort was 42.5 years, 89% were women, and most (69.6%) had migraine without aura. The mean number of monthly migraine days during the 30-day period prior to baseline was 11.1 days. This number tended to decrease over time with treatment, with an overall mean decrease of 2.0 days. Most patients (75.0%) polled at week 52 were ‘completely’ or ‘very satisfied’ with rimegepant treatment, with a very high proportion (82.2%) declaring they preferred rimegepant over their previous therapy. The most commonly reported adverse events were upper respiratory tract infection (9.5%) and nasopharyngitis (7.8%). Serious adverse events were rare (2.9%) and included accidental overdose, appendicitis, and osteoarthritis (in 3 patients each), and pneumonia (in 2 patients).

Overall, the authors concluded that long-term treatment with rimegepant 75 mg for acute treatment of migraine was well-tolerated and led to a reduction in mean monthly migraine days through 52 weeks in patients with at least 6 monthly migraine days. Furthermore, they added that “the observation that the number of mean monthly migraine days reduced over time suggests that medication-overuse headache is unlikely to be associated with rimegepant.”

1. Yu S, et al. Use of rimegepant 75 mg for the acute treatment of migraine is associated with a reduction in monthly migraine days – a pooled analysis of 2 open-label trials. 18^th European Headache Congress, 4–7 December 2024, Rotterdam, the Netherlands.

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Posted on 6 January 2025