Rimegepant, a drug belonging to a new generation of acute migraine headache treatments was found to eliminate pain and reduce bothersome symptoms for people with migraine, reported a large-scale trial published in The New England Journal of Medicine.
Rimegepant is an oral calcitonin gene–related peptide receptor (CGRP) antagonist.
The trial assessed rimegepant more than 1,000 men and women with migraine at 49 centers in the U.S. The participants were instructed to take a tablet of rimegepant, or a matching placebo tablet, during a migraine attack, once moderate or severe pain developed. Before taking the tablet and for 48 hours afterwards, patients answered questions in an electronic diary concerning their pain and their most bothersome symptoms. Participants chose their most bothersome symptom from a list, including intolerance to light, intolerance to loud sounds, or nausea.
Two hours after taking their tablets, 19.6% of patients in the rimegepant group were free from pain compared with 12.0% in the placebo group — a statistically significant difference. Freedom from their most bothersome symptoms occurred in 37.6% of patients in the rimegepant group and 25.2% in the placebo group. Side effects were minimal, with nausea and urinary tract infections the only adverse effects reported in more than 1% of patients in each group and no adverse CVD effects observed, reported the researchers.
“These results confirm that rimegepant’s mechanism of action — blocking the CGRP pathway — effectively relieves pain and associated symptoms that occur during acute migraine attacks,” said the study author Richard B. Lipton, M.D.
Migraine headache affects about 12 to 14% of people, or more than a billion individuals worldwide. This chronic neurologic disorder involves periodic attacks of head pain along with symptoms that may include nausea as well as sensitivity to light and sound. More than three-quarters of migraine sufferers experience at least one migraine attack per month, and more than half are severely impaired during their attacks.
The study was led by researchers at Albert Einstein College of Medicine and Montefiore Health System.