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Doctor, I have frequent migraines. Can taking rimegepant prevent migraines?

In adults who have migraines 4 to 18 days per month, rimegepant reduced the number of migraine days people experienced per month by an average of less than 1 day.

What is the evidence?

SUMMARY OF FINDINGS

Rimegepant vs placebo for prevention of migraines

Outcomes During Weeks 9-12RimegepantPlaceboEffect

Change in average number of migraine days per month

4 fewer

migraines per month

3.5 fewer

migraines per month

People who took rimegepant had about half of a day fewer migraines

Greater than or equal to 50% reduction in average number of moderate or severe migraine days per month

49 out of 100 people41 out of 100 peopleAbout 8 more people out of 100 people who took rimegepant had 50% or greater reduction in the average number of moderate or severe migraine days per month

The number of people with an adverse event was the same in both groups (36%)


What kind of study was this?

This was a randomized controlled trial(RCT).

Who? This study included 747 adults (average age 41 years; 83% women; 82% white) who have 4 to 18 moderate or severe migraines per month. They also had at least a 1-year history of migraine beginning before age 50 . Pregnant women and people with medical conditions that doctors thought would put them at risk for adverse events were excluded.

What? The study compared rimegepant with placebo after a 4-week observation period. Study participants had to have at least 6 migraine days during the 4-week observation period to be included in the study. All participants were allowed to take one preventative migraine drug during the study that was not related to rimegepant.

Rimegepant

vs

Placebo

Rimegepant 75 mg tablet every second day for 12 weeks



Placebo every second day for 12 weeks: A tablet containing an inactive substance that has no effect on the outcome. Sometimes, it is referred to as a "sugar pill."


Why was this research done?

Rimegepant is a drug that is currently used to treat migraines. It helps to reduce pain by changing the amount of a natural substance in the brain. Researchers in this study wanted to know if rimegepant could also be used to prevent migraines. The results showed that rimegepant reduced the number of migraine days per month by about one-half day. Because this is an average number across all of the people in the study, it means that rimegepant reduced migraines by more than a day for some people while for others, it had no effect. The potential of a small benefit with rimegepant needs to be balanced against the need to take a medication every second day.

This Evidence Summary is based on the following article:

Croop R, Lipton RB, Kudrow D, et al. Oral rimegepant for preventive treatment of migraine: a phase 2/3, randomised, double-blind, placebo-controlled trial. Lancet. 2021 Jan 2;397(10268):51-60. doi: 10.1016/S0140-6736(20)32544-7. Epub 2020 Dec 15. PubMed

Published: Monday, March 15, 2021
Last Updated: Tuesday, July 13, 2021