Clinically Meaningful Migraine Prevention: Richard B. Lipton, MD


The director of the Montefiore Headache Center discussed how rimegepant was observed to produce clinically meaningful improvements in migraine prevention.

“I anticipate in clinical practice that the people who benefit from rimegepant will continue taking it preventively, the people who don't benefit will stop taking it preventively and they'll move on to something that might work for them.”

Data from a recent multicenter, phase 2/3, randomized, double-blind, placebo-controlled trial (NCT03732638) suggest that rimegepant (Nurtec ODT; Biohaven), approved for the treatment of acute migraine in February 2020, is also 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 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 spoke to Lipton to learn more about how rimegepant compares to other migraine treatments in terms of efficacy and adverse effect profile. Lipton expanded on what qualifies medications as clinically meaningful and how rimegepant fits into that category.

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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