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Immediate initiation of once-daily 75 mg rimegepant oral disintegrating tablet during Ramadan markedly reduces headache frequency, duration, and severity in fasting individuals with migraine when compared to delayed initiation.
A randomized open-label trial has demonstrated that rimegepant, a calcitonin gene-related peptide (CGRP) receptor antagonist, may offer effective short-term prevention of headaches triggered by fasting during Ramadan in migraine-affected patients.
The study involved 105 adults (aged 18 to 65), all diagnosed with migraine and a history of fasting-related headaches. Participants were assigned to one of two groups: an Immediate Start arm, receiving a daily 75 mg oral disintegrating tablet of rimegepant from the first week of fasting through week 4 (n=52), or a Staggered Start arm, beginning treatment in week 2 and continuing through week 4 (n=53).
The main outcome measure was the difference in the number of headache days of any severity during the first week of fasting. Results revealed that the Immediate Start group experienced markedly fewer headache days during week 1 when compared to the Staggered Start group (1.74 days vs. 2.92 days). Furthermore, the total duration of headaches in the Immediate Start group was notably shorter during week 1 (10.1 hours vs. 20.0 hours) and week 4 (0.9 hours vs. 4.6 hours).
Moderate-to-severe headaches were also considerably reduced in both frequency and duration for the Immediate Start group during the first week. Over the entire 4-week period, those starting treatment immediately exhibited fewer moderate-to-severe headache days per week (0.60 vs. 1.00 days) and showed a trend toward fewer overall headache days of any severity (1.05 vs. 1.50 days).
Though the use of rescue medication tended to be lower in the Immediate Start arm throughout the study, differences were not statistically significant.
Importantly, no adverse events were reported, and more than 80% of participants expressed satisfaction with the treatment by study end. These findings suggest that once-daily rimegepant 75 mg oral disintegrating tablet is a well-tolerated and potentially effective option for short-term prevention of fasting-triggered headaches in migraine sufferers during Ramadan.
Cephalalgia
A randomized open-label study to evaluate the effectiveness and safety of once-daily rimegepant 75 mg orally disintegrating tablet for the short-term preventive treatment of fasting-triggered headache in individuals with migraine
Taoufik Alsaadi et al.
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