A new migraine drug might offer an alternative to people who do not get relief from current medications. A phase three trial for a medication called rimegepant showed that it could be effective at freeing some people from their worst migraine symptoms. The results of the trial have been published in the New England Journal of Medicine.
Rimegepant belongs to a new class of drugs known as CGRP inhibitors. CGRP is a small protein believed to play a key role in generating migraine pain. Three CGRP inhibitors are already approved by the FDA. All are injected drugs that are used regularly to prevent migraine attacks.
Rimegepant is an oral medication that treats migraines in progress. In the phase three trial of the drug, the researchers recruited 1,186 adults with migraines rated moderate to severe in intensity that struck two to eight times per month. The researchers randomly assigned 537 people to take one dose of rimegepant the next time they had a migraine; 535 were given an identical-looking placebo tablet. Electronic diaries were used by the patients to rate their symptoms before and after taking the tablet.
About 20 percent of patients who used one dose of rimegepant reported that they were pain-free within two hours, compared with 12 percent of placebo users. Many other patients, while not pain-free, still got relief. Of rimegepant users, 58 percent said their pain had dissipated, versus 43 percent of placebo users.
Lead researcher of the study, Dr. Richard Lipton, directs the Montefiore Headache Center at Albert Einstein College of Medicine in New York City. He is also a paid consultant to rimegepant developer Biohaven Pharmaceuticals, which funded the trial. The drug has not yet been approved by the U.S. Food and Drug Administration. Research still must be conducted on the long-term effects of the drug.