Cutting Down Monthly Headache Days in Migraine: Richard B. Lipton, MD


The director of the Montefiore Headache Center discussed the impact of halving headache days for patients with migraine.

“What I say to patients is, ‘there's a 50% chance that you're going to have at least a 50% reduction in the number of headache days you have per month.’ And if you go from 8 days a month to 4 days a month, and you have something that you can take that also works acutely, that can be life changing for people.”

Rimegepant (Nurtec ODT; Biohaven), approved for the treatment of acute migraine in February 2020, has also been shown to be effective in migraine prevention when taken every other day.1,2

A recent multicenter, phase 2/3 randomized, double-blind, placebo-controlled trial (NCT03732638) found that 49% (95% CI, 44-54; n = 171) of patients on rimegepant had at least a 50% reduction in the mean number of moderate or severe migraine days per month in the last month of double-blind treatment as compared to 41% (95% CI, 36-47; n = 142) of patients on placebo.

NeurologyLive reached out to study coauthor Richard B. Lipton, MD, professor and vice chair of neurology, Albert Einstein College of Medicine, and director, Montefiore Headache Center, and colleagues, to learn more about rimegepant’s efficacy in preventing migraine. Lipton also discussed the clinical importance of a 50% reduction in headache days.

1. Kroop 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 Neurol. Published online December 15, 2020. doi: 10.1016/S0140-6736(20)32544-7
2. Rimegepant Approved by FDA for the Acute Treatment of Migraine in Adults. News release. February 27, 2020. Accessed January 6, 2021.
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