Shengyuan Yu (Beijing, CN), Terence Fullerton (Groton, CT, US), Glenn Pixton (Groton, CT, US), Yunjun Zou (Shanghai, CN), Qi Zhong (Shanghai, CN), Hua Zhu (Shanghai, CN)
Rimegepant, a calcitonin gene-related peptide receptor antagonist, is indicated for acute and preventive treatment of migraine in adults. This analysis examined whether long-term use of rimegepant for acute treatment of migraine may provide an additional preventive effect.
Data were pooled from 2 uncontrolled long-term open-label trials of rimegepant (NCT03266588, NCT05371652). Participants in this analysis had ≥6 monthly migraine days (MMDs) during a 30-day observation period (OP). Participants took oral rimegepant 75 mg as needed, up to once per day for up to 52 weeks, for acute treatment of migraine attacks of any severity. Adverse events (AEs) and change in the number of MMDs (relative to the OP) were summarized descriptively.
Of 1288 treated participants, 68.7% reported an AE, 4.7% reported a severe AE, 2.9% reported a serious AE, and 2.4% reported an AE leading to rimegepant discontinuation. Upper respiratory tract infection (9.5%), nasopharyngitis (7.8%), and COVID-19 (7.6%) were reported by ≥5% of participants. Among 1269 participants included in the MMD analysis, the mean (SD) number of MMDs during the OP was 11.1 (4.3). The number of MMDs decreased, relative to the OP, over the course of 52-week treatment with rimegepant (Table). The mean (SD) change in MMDs was –2.0 (4.6) for the overall 52-week treatment period.
Long-term use of rimegepant 75 mg for acute treatment of migraine, up to once per day for up to 52 weeks, was well tolerated and may provide an additional preventive effect as evidenced in a reduction in MMDs. The observation that MMDs were reduced over time suggests that medication overuse headache is unlikely to be associated with rimegepant.