Richard B. Lipton, MD: Achieving Simultaneous Acute and Preventive Migraine Treatment


The director of the Montefiore Headache Center discussed how his team’s findings can change the way physicians think about treating migraine.

“Historically, we've drawn a bright line between acute and preventive treatments... the fascinating thing, which is both a conceptual breakthrough and potentially a therapeutic breakthrough, is that blocking calcitonin gene-related peptide [receptor] makes acute attacks better, but it also prevents attacks if you have a way of keeping the drug around for a long time.”

Data from a recent multicenter, phase 2/3, randomized, double-blind, placebo-controlled trial (NCT03732638) showed that rimegepant (Nurtec; Biohaven), is effective in migraine prevention when taken every other day (QOD) and is well-tolerated in patients with the headache disorder.1 Rimegepant was approved for the acute treatment of migraine in February 2020.2

NeurologyLive spoke with study co-author Richard B. Lipton, MD, professor and vice chair of neurology, Albert Einstein College of Medicine, and director, Montefiore Headache Center, to learn more about the potential of rimegepant to act as both an acute and preventive treatment of migraine. The agent is a calcitonin gene related peptide (CGRP) receptor antagonist, a mechanism of action that appears to be key to this potential.

Lipton discussed how his team’s findings can challenge the status quo of treating migraine and can open up preventive treatment to a broader range of patients. He also expounded on how the new findings can change the way one thinks about migraine.

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. Biohaven Pharmaceuticals. February 27, 2020. Accessed January 6, 2021.
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