Rimegepant vs. Monoclonal Antibodies for Migraine Prevention: Richard B. Lipton, MD


The director of the Montefiore Headache Center discussed how rimegepant has certain benefits over monoclonal antibodies, such as a much shorter half-life.

“A lot of people don't want injections. That's one challenge. The other challenge is other drugs have a half-life of about a month... Rimegepant has a 12-hour half-life, so it's 95% out of your body in 3 days. So, it's better for women of childbearing potential, it's better since the drug doesn't require an injection.”

Data from a recent multicenter, phase 2/3, randomized, double-blind, placebo-controlled trial (NCT03732638) suggest that rimegepant (Nurtec ODT; Biohaven) is effective in migraine prevention when taken every other day.1 The medication was previously approved for the treatment of acute migraine in February 2020.2

Researchers, including study coauthor Richard B. Lipton, MD, professor and vice chair of neurology, Albert Einstein College of Medicine, and director, Montefiore Headache Center, 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 Lipton to learn more about rimegepant’s potential to both treat and prevent migraines. Lipton compared rimegepant for migraine prevention to the monoclonal antibodies, the current standard for migraine prevention. 

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 February 22, 2021. https://americanheadachesociety.org/news/rimegepant-acute-migraine-treatment/
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