Preventing While Treating Acute Migraines: Richard B. Lipton, MD


The director of the Montefiore Headache Center discussed his hopes that rimegepant will be approved as a preventive treatment of migraine.

“Instead of saying to a patient, ‘you need an acute treatment, you need a preventive treatment; here are 2 drugs for your problem’, I can say, ‘here's 1 drug for your problem, you can take it every other day if you have frequent headaches, and that'll cut down your headache frequency.’”

Rimegepant (Nurtec; Biohaven), approved for the acute treatment of migraine in February 2020, has been shown to be effective in migraine prevention when taken every other day.1,2 Data from a multicenter, phase 2/3, randomized, double-blind, placebo-controlled trial (NCT03732638) suggested that rimegepant is well-tolerated in patients with the headache disorder as well as efficacious in migraine prevention.

Rimegepant, a calcitonin gene related peptide (CGRP) receptor antagonist, was investigated by study co-author Richard B. Lipton, MD, professor and vice chair of neurology, Albert Einstein College of Medicine, and director, Montefiore Headache Center and colleagues. Its mechanism appears to be key to achieving acute and preventive migraine care.

NeurologyLive spoke with Lipton to learn more about the advantages to only having to prescribe 1 medication to patients for both acute and preventive care. He spoke about how the current treatment landscape of migraine is siloed into ‘acute’ and ‘preventive’ and how a new way of thinking is needed to combine these 2 approaches.

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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