Further Research on Rimegepant for Migraine Prevention: Richard B. Lipton, MD


The director of the Montefiore Headache Center discussed the research he would like to see into the treatment, including the potential of combination approaches.

“I’d like to know a little bit more about how rimegepant works, a little bit more about the precise mechanism. I'd like to know if calcitonin gene-related peptide antagonists work on headache types other than migraine, like post traumatic headache, which looks a whole lot like migraine but is initiated by head injury.”

Data from a recent multicenter, phase 2/3, randomized, double-blind, placebo-controlled trial (NCT03732638) suggest that rimegepant (Nurtec ODT; Biohaven), previously approved for the treatment of acute migraine in February 2020, is effective in migraine prevention when taken every other day.1,2

Study coauthor Richard B. Lipton, MD, professor and vice chair of neurology, Albert Einstein College of Medicine, and director, Montefiore Headache Center, and colleagues found that patients on rimegepant, a calcitonin gene-related peptide (CGRP) antagonist, had a least square mean change of –3.6 (95% CI, –4.0 to –3.2) in the number of total migraine days per month over the 3-month treatment period as compared to –2.7 (95% CI, –3.1 to –2.3; P = .0017) in the placebo group.

NeurologyLive reached out to Lipton to learn more about his thoughts on the potential of CGRP antagonists in preventing migraine. He also discussed further research he would like to see conducted, including investigating the mechanism of rimegepant further and combination therapies.

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. 2021:397(10268):51-60 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 February 22, 2021. https://americanheadachesociety.org/news/rimegepant-acute-migraine-treatment/
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