Efficacy and tolerability of rimegepant in acute migraine treatment :- Medznat
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Real-world insights on rimegepant for acute migraine treatment

Rimegepant Rimegepant
Rimegepant Rimegepant

Rimegepant, an innovative oral calcitonin gene-related peptide (CGRP) receptor antagonist, has recently gained approval for acute migraine care. 

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Key take away

Rimegepant (75 mg) effectively relieves migraine in real-world settings, with 44.7% achieving pain freedom at 2 hours, and is well-tolerated with mostly mild adverse events.

Background

Rimegepant, an innovative oral calcitonin gene-related peptide (CGRP) receptor antagonist, has recently gained approval for acute migraine care. While its usefulness has been portrayed in randomized clinical trials (RCTs), its real-world effectiveness and tolerability remain unexplored. The GAINER study—a prospective, multicenter investigation—sought to bridge this gap by investigating rimegepant in routine clinical practice.

Method

Volunteers were directed to manage a single migraine episode using a 75 mg orally disintegrating tablet of rimegepant. Using a dedicated diary, they recorded migraine characteristics at baseline and at 30-minute intervals up to 2 hours post-dose, with a follow-up at 24 hours. Conducted across 16 headache centers, the study assessed two key outcomes: (i) pain freedom at 2 hours post-dose, and (ii) the occurrence of treatment-emergent adverse events.

Result

In this real-world study, 103 migraine sufferers (74.8% female, mean age 44.4 years) were enrolled, including 24.3% with chronic migraine, of whom 44.0% had a concurrent diagnosis of medication overuse headache. The cohort had failed an average of 2.7 prior preventive treatments and experienced a mean of 9.6 migraine days per month. At the time of rimegepant intake, 40.8% reported severe migraine intensity.

Pain freedom at 2 hours was attained by 44.7% (46/103) of volunteers. Baseline pain severity did not markedly impact this outcome (p = 0.316), but earlier administration (within 1 hour of onset) was linked with a higher response rate (p = 0.032). Mild adverse events occurred in 15.5% of cases (16/103), primarily fatigue (n = 6), gastrointestinal distress (n = 6), excess sleepiness (n = 4), and transient cognitive challenges (n = 3). In 85.4% of cases (88/103), tolerability was rated as good to excellent.

Conclusion

The findings supported rimegepant's potential for acute migraine care in real-world settings, including those with episodic or chronic migraine, medication overuse, and multiple prior preventive treatment failures.

Source:

The Journal of Headache and Pain

Article:

Effectiveness and tolerability of rimegepant in the acute treatment of migraine: a real-world, prospective, multicentric study (GAINER study)

Authors:

Luigi Francesco Iannone et al.

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