Abstract
Introduction
For preventive migraine treatment, understanding an intervention's onset, extent of action, and duration can help set realistic treatment expectations and may help prevent both premature discontinuation and reduce unnecessary prolonged exposure. Rimegepant is an oral calcitonin gene-related peptide receptor (CGRP) antagonist with demonstrated efficacy in the acute and preventive treatment of migraine. This post hoc analysis aimed to assess the onset of benefits of rimegepant 75 mg for the preventive treatment of migraine.Methods
Median (25th, 75th percentiles) time to first and sustained reductions in weekly migraine days (WMDs) were estimated. Improvements from baseline were evaluated in 10% increments. Time to first improvement was based on the first week that a reduction of a particular magnitude was achieved, and time to sustained improvement was defined as the week that a reduction at a particular level was achieved and that persisted, on average, until study end.Results
Among 370 participants, the median (25th, 75th percentiles) time to first reduction in WMDs of ≥ 50% was 2 (1, 4) weeks. Thus, 50% of patients are expected to experience ≥ 1 week with a ≥ 50% reduction in WMDs within the first 2 weeks. The median (25th, 75th percentiles) time to a sustained reduction in WMDs of ≥ 50% was 3 (1, 14) weeks. Accordingly, 50% of patients are expected to experience a ≥ 50% reduction in WMDs by week 3 and to maintain this improvement, on average, up to week 64.Conclusion
Following rimegepant 75-mg treatment initiation, it is expected that 50% of patients will experience first ≥ 50% reduction in WMDs by week 2 and sustained reduction by week 3. Graphical abstract available for this article.Clinical trial registration
ClinicalTrials.gov number: NCT03732638. https://www.Clinicaltrials
gov/study/NCT03732638 .